Subcutaneous infusion ports for administration of parenteral nutrition at home.
We evaluated 15 adult patients in whom subcutaneous infusion ports (SIP) were implanted exclusively for the administration of parenteral nutrition at home (HPN). The SIP were in place for a total of 4,939 days, with a mean of 259 days, and used for delivery of HPN 2,534 times. The devices were implanted on the anterior part of the wall of the chest and the catheters introduced percutaneously through the subclavian vein into the superior vena cava under fluoroscopic guidance. There were two episodes of sepsis related to insertion of catheters (1.0 per 6.8 catheter years) and six mechanical complications. Three patients with multiple previous episodes of sepsis associated with Hickman catheters (long term Silastic [silicone rubber] central venous catheter) had no further infections after conversion to SIP. All eight patients with previous Hickman catheters preferred the SIP. The SIP compare favorably with Hickman catheters with respect to the incidence of sepsis related to the catheters and mechanical complications. SIP are our current choice for cyclic administration of HPN because of optimal acceptance by patients and a low rate of major complications.
Pomp
A
A
Department of Surgery, Rhode Island Hospital, Providence 02903.
Caldwell
M D
MD
Albina
J E
JE
D000328:Adult; D000368:Aged; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D002408:Catheters, Indwelling / Q000009:adverse effects; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007260:Infusion Pumps; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition / Q000295:instrumentation* / Q000379:methods; D010342:Patient Acceptance of Health Care; D010369:Pectoralis Muscles; D012648:Self Care / Q000379:methods*; D013350:Subclavian Vein; D013997:Time Factors; D014683:Vena Cava, Superior