title: Portacaths are safe for long-term regular blood transfusion in children with sickle cell anaemia.
abstract: Peripheral venous access in children with sickle cell anaemia (SCA) requiring regular blood transfusions can become difficult over time. Previous reports have suggested the use of totally implantable venous access devices, Portacaths (PAC) in this patient group are associated with unacceptable high rates of complications. We present our experience in seven children with SCA over a 9-year period. Seven devices were placed for a total of 9754 PAC days during the study period. The median age at insertion was 6.3 years (range 3-15 years). The rate of PAC associated infection was 0.2 per 1000 PAC days. There were no episodes of thrombosis. The median length of time in situ during the study period was 3.7 years (range 1.3-7.5 years). Our experience highlights the safe and reliable use of PAC in children with SCA requiring regular blood transfusions when venous access has become a major problem.
authors.affiliation: Department of Paediatric Haematology, King's College London School of Medicine, King's College Hospital, Denmark Hill, London SE5 9RS, UK. jacklbartram@hotmail.com
authors.forename: Jack L
authors.initials: JL
authors.lastname: Bartram
authors.forename: Sandra
authors.initials: S
authors.lastname: O'Driscoll
authors.forename: Austin G
authors.initials: AG
authors.lastname: Kulasekararaj
authors.forename: Susan E
authors.initials: SE
authors.lastname: Height
authors.forename: Moira
authors.initials: M
authors.lastname: Dick
authors.forename: Shailesh
authors.initials: S
authors.lastname: Patel
authors.forename: David C
authors.initials: DC
authors.lastname: Rees
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000628:therapy*; D055499:Catheter-Related Infections / Q000209:etiology; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D020878:Device Removal; D004868:Equipment Failure; D017707:Erythrocyte Transfusion / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D013927:Thrombosis / Q000209:etiology