Document Detail

Experience with the Port-A-Cath in sickle cell disease.
MedLine Citation:
PMID:  8866138     Owner:  NLM     Status:  MEDLINE    
Peripheral vein access is often a problem in patients with sickle cell disease (SCD). Totally implantable venous access devices (TIVAD) have offered other groups of patients safe long-term venous access. We reviewed our own experience with the use of a Port-A-Cath device in five patients with SCD undergoing exchange transfusion programmes. All five lines required removal due to infection associated with SBE, septic arthritis, pulmonary embolus and axillary vein thrombosis. The organisms involved were Staphylococcus aureus (3), Staphylococcus epidermidis (1) and Streptococcus sp. (1). The median working life of the catheters was 240 days (range 61-428). The median length of time from presentation to the diagnosis of a line-associated infection was 29 days (range 1-58). The rate of complications (0.4 per 100 patient days) in this small group of patients contrasts with the lower rates in patients with HIV and malignancy (0-0.1 per 100 patient days). Our results suggest that patients with SCD suffer an unacceptable incidence of infective complications associated with the Port-A-Cath. Bone infection is more common where there is pre-existing infarcted tissue. While these systems provide a valuable tool, our experience has led us to discontinue the use of TIVADs in SCD.
C E McCready; H A Doughty; T C Pearson
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Clinical and laboratory haematology     Volume:  18     ISSN:  0141-9854     ISO Abbreviation:  Clin Lab Haematol     Publication Date:  1996 Jun 
Date Detail:
Created Date:  1997-03-28     Completed Date:  1997-03-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7907061     Medline TA:  Clin Lab Haematol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  79-82     Citation Subset:  IM    
Department of Haematology, St Thomas' Hospital, London, UK.
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MeSH Terms
Anemia, Sickle Cell / complications,  therapy*
Arthritis, Infectious / complications,  microbiology
Axillary Vein
Catheterization, Central Venous* / adverse effects
Exchange Transfusion, Whole Blood*
Pregnancy Complications, Hematologic / therapy
Pulmonary Embolism / complications
Retrospective Studies
Staphylococcal Infections / complications
Streptococcal Infections / complications
Thrombosis / complications

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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