Catheter survival during long-term insulin therapy with an implanted programmable pump. The Implantable Insulin Pump Trial Study Group.
OBJECTIVE
To survey catheter complications and to analyze catheter survival during long-term intraperitoneal and intravenous insulin therapy with an implanted programmable pump with a sideport.


METHODS
Catheter occlusions were documented by measuring dynamic catheter resistance. Catheter migrations or breaks were demonstrated by X ray. When flushing the catheter with buffer solution through the sideport failed to clear the occlusion, catheters were replaced or laparoscopy was performed for the excision of fibrous tissue growth. Broken or migrated catheters were replaced.


RESULTS
Occlusions were the most common catheter complications, and the majority of them (79% intraperitoneal and 84% intravenous) were cleared by flushing the catheter. Survival at 3 years was significantly higher for intraperitoneal catheters compared with intravenous catheters (60% intraperitoneal and 22% intravenous).


CONCLUSIONS
Nonsurgical management of catheter occlusions contributed to extend catheter lifetime. Intraperitoneal catheters have a lower morbidity and a higher survival than intravenous catheters.
Scavini
M
M
Istituto Scientifico H San Raffaele, Milan, Italy. scavinm@mihsra.hsr.it
Galli
L
L
Reich
S
S
Eaton
R P
RP
Charles
M A
MA
Dunn
F L
FL
D002408:Catheters, Indwelling / Q000009:adverse effects; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D004282:Documentation; D004868:Equipment Failure; D006801:Humans; D007262:Infusions, Intravenous / Q000009:adverse effects; D007263:Infusions, Parenteral / Q000009:adverse effects; D007332:Insulin Infusion Systems / Q000009:adverse effects; D011336:Probability; D013997:Time Factors