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Central venous catheters in patients with AIDS
H E Goodman1, R P Brettle, B Stevenson
1Infectious Disease Unit, City Hospital, Edinburgh, UK.
International Journal of STD & AIDS
|July 1, 1997
Summary
Central venous catheters (CVCs) are valuable for AIDS patients receiving home intravenous therapy. While complications like pneumothorax and sepsis occur, CVCs remain a viable option, especially with Portacaths, though infection reduction strategies are needed.
Area of Science:
- Medical Science
- Infectious Diseases
- Oncology
Background:
- Central venous catheters (CVCs) are essential for long-term intravenous therapy in patients with Acquired Immunodeficiency Syndrome (AIDS).
- These patients face increased risks of CVC-related complications, particularly bacterial infections, due to their compromised immune status.
Purpose of the Study:
- To evaluate the safety and complication rates of CVCs in patients with AIDS receiving intravenous therapy.
- To identify common complications, causative organisms, and factors influencing CVC survival in this patient population.
Main Methods:
- A 6-year retrospective review of 33 patients with AIDS who received CVCs for hospital and home intravenous therapy.
- Analysis of 53 CVC insertions, focusing on complication rates per 100 catheter days (cd), types of complications, isolated organisms, and CVC survival.
Main Results:
- Overall complication rate was 28% per insertion, with pneumothorax (8%) and sepsis (0.69/100 cd) being most frequent. Serious catheter sepsis occurred at 0.33/100 cd.
- Staphylococci spp. were the most common pathogens (71%). Median CVC survival was 88 days (118 days excluding temporary catheters).
- Portacath devices showed the lowest infection rate (0.33/100 cd). Previous injection drug use (IDU) did not significantly impact infection rates.
Conclusions:
- Central venous catheters can be safely used for home intravenous therapy in patients with AIDS, even with a history of injection drug use.
- Strategies to minimize infection-related complications are necessary to improve CVC longevity and patient outcomes.
- Portacath devices may offer a lower risk of infection compared to other CVC types.