Despite the major diagnostic and therapeutic advantages of tiered-therapy ICDs, a significant proportion of patients continue to experience hardware-related complications or receive inappropriate shocks.

Prolonged central venous catheterisation is associated with a substantial risk of line related infection, which may be reduced when a chlorhexidine/silver-sulfadiazine coated catheter (ARROWgard Blue(TM)) is used in medical or surgical ICU patients. However, no data is available from severely immunocompromised patients. We therefore performed an initial exploratory study among patients with haematological malignancy, aplastic anaemia or bone marrow transplantation. The study was terminated after the 12th catheter insertion. Eight of 11 assessable catheters developed a notable degree of mechanical dysfunction, which directly led to catheter removal in 2 patients. Six of the 11 catheters were unstable. Catheter-related infection occurred in 5 instances. Only 1 catheter functioned normally and was unassociated with infection. The ARROWgard Blue(TM) catheter cannot be recommended for prolonged use in these patients.

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