[Subcutaneous venous reservoirs: comparative study of their efficacy in patients with AIDS versus oncology and hematology patients].
BACKGROUND
Chronic venous access may constitute a serious problem in some patients and the subcutaneous venous reservoirs have demonstrated to be a useful alternative. AIDS patients require intense pharmacologic treatment, thus the use of subcutaneous venous reservoirs may be specially useful. However, the prevalence of septic type complications following placement of the subcutaneous venous reservoirs in these patients is particularly high.


OBJECTIVE
To know the efficacy of subcutaneous venous reservoirs in the AIDS population and compare the results in a non AIDS population.


METHODS
All the subcutaneous venous reservoirs placed between January 1990 and December 1992 were prospectively studied with two groups being established: Group I: patients with positive serology for HIV and who achieved criteria of AIDS requiring placement of a subcutaneous venous reservoirs. Group II: All the remaining patients in whom a subcutaneous venous reservoirs was placed during the same period of time.


RESULTS
The incidence of infection was higher in group I (AIDS) with respect to group II (0.1 versus 0.014 infections/100 catheters/day, p < 0.01) and the non septic complications were higher in group II (3.6% versus 12.7%, p < 0.0004). The catheters were most frequently used in group I with respect to group II (12.7 +/- 7.1 versus 3.3 +/- 4.9 punctures/month) but the period was use longer in group II (13.7 +/- 9.2 versus 4.3 +/- 3.1 months, p < 0.0001).


CONCLUSIONS
The population of AIDS patients may benefit greatly from the systematic use of subcutaneous venous reservoir due to their clinical and therapeutic characteristics. Nonetheless greater risk of infection may occur in these patients because of the greater need for punctures with respect to the other indications for placement of these catheters.
Moral
A
A
Servicio de Cirugía, Hospital Clínic i Provincial, Barcelona.
Targarona
E M
EM
Mallolas
J
J
Martínez
J
J
Pros
I
I
Valverde
M
M
Palombo
H
H
Trias
M
M
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000328:Adult; D000368:Aged; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation*; D002408:Catheters, Indwelling / Q000009:adverse effects; D005069:Evaluation Studies as Topic; D005260:Female; D006402:Hematologic Diseases / Q000150:complications; D006801:Humans; D015994:Incidence; D007239:Infections / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D011030:Pneumothorax / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D019736:Prostheses and Implants / Q000009:adverse effects; D013350:Subclavian Vein
Reservorios venosos subcutáneos: estudio comparativo de su eficacia en pacientes afectados de sida respecto a pacientes oncológicos y hematológicos.