A comparative study of polyurethane and silicone cuffed-catheters in long-term home total parenteral nutrition patients.
OBJECTIVE
The purpose of this study was to report our compared experience of long-term complications with polyurethane (LeaderCuff) and silicone (Lifevac) tunnelled, cuffed catheters in home adult TPN patients.


METHODS
All catheters were inserted by a percutaneous technique under local anaesthesia.


RESULTS
Forty silicone catheters were inserted in 31 patients and 13 polyurethane catheters were inserted in 11 patients totaling a total experience of 480 months and 175 months respectively. Mean catheter life span was 12 months (range: 0.25-47) and 13 months (range: 3-44) for Lifevac and LeaderCuff catheters, respectively. Complication rates (expressed as patient-year of TPN) were no significantly different for Lifevac and LeaderCuff catheters: sepsis (0.15 vs 0.14), obstruction (0.05 vs 0), dislodgement (0.13 vs 0.07) and thrombosis (0 vs 0.14). The fracture rate was 20 times lower for Lifevac than for LeaderCuff (P << 0.01): in all cases, this mechanical problem was due to the dysfunction of the detachable flow-control device.


CONCLUSIONS
Both Lifevac and LeaderCuff catheters enable safe, long-term, venous access and prevent, in most cases, inadvertent catheter dislodgement. There is little evidence, from our study, to support the hypothesis that polyurethane catheters offer more security than silicone catheters in home TPN adult patients.
Beau
P
P
Gastroenterology and Nutritional Support Unit, University Hospital, Poitiers, 86021, France.
Matrat
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D002404:Catheterization / Q000295:instrumentation*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016562:Parenteral Nutrition, Home Total / Q000295:instrumentation*; D011140:Polyurethanes; D012828:Silicones; D013203:Staphylococcal Infections / Q000209:etiology; D013997:Time Factors; D020246:Venous Thrombosis / Q000209:etiology
D011140:Polyurethanes; D012828:Silicones