Complications of long and intermediate term venous catheters in cystic fibrosis patients: A multicenter study

Abstract

This is the first longitudinal, multicenter assessment of complication rates for PICCs and TIVADs in a large cohort of adults and children with CF. Specific patient- and catheter-related characteristics were associated with increased risk of complications. Center effects on complication rates were observed for PICCs.

Complications related to totally implantable venous access devices in children and adults following lung transplantation

“…TIVADs are preferred over PICCs for longer duration of intravenous therapy due to the lower incidence of infectious, thrombotic, and mechanical complications . In prior studies of cystic fibrosis patients, for example, who comprised the majority of our study cohort, all‐cause TIVAD‐related complications range from 0.43 to 0.91 per 1000 catheter‐days and infectious complications range from 0.15 to 0.26 per 1000 catheter‐days . By contrast, PICC complications have been reported in up to 20% of patients with cystic fibrosis who have indwelling PICCs for a duration of 2‐3 weeks .…”

“…The decision to use TIVADs in patients with advanced lung disease is dependent on many factors, including frequency and duration of intravenous treatments, patency of peripheral veins for intermittent therapy, and patient preference . TIVADs are preferred over PICCs for longer duration of intravenous therapy due to the lower incidence of infectious, thrombotic, and mechanical complications . In prior studies of cystic fibrosis patients, for example, who comprised the majority of our study cohort, all‐cause TIVAD‐related complications range from 0.43 to 0.91 per 1000 catheter‐days and infectious complications range from 0.15 to 0.26 per 1000 catheter‐days .…”

“…Available venous access devices include peripherally inserted central venous catheters (PICCs), tunneled central venous cuffed catheters, and totally implantable venous access devices (TIVADs), also known as venous ports. TIVADs are the preferred venous access device for longer duration of therapy and have the benefit of reduced infection and mechanical complications rates compared to PICCs and tunneled central catheters …”

Cystic fibrosis year in review 2018, part 2

“…Venous access devices are widely used for intravenous antibiotic (IVAB) therapy in CF. The frequency of, and risk factors for, complications of implantable venous access devices (TIVADs) or peripherally inserted central venous catheters (PICCs) was retrospectively studied in adults and children with CF over 8 years at three accredited care centers in the US . Complications were symptomatic, as no protocol for thrombosis screening was utilized.…”

“…IQR] 1301 kcal/d vs 686; P < .0001) and proportion of energy intake (median [IQR] 44%[34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51] vs 31%[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43]; P < .0001). Thus, while children with CF met their energy requirements and ate ample fat, this was largely due to ingestion of EDNP foods.…”