Infection of totally implantable venous access devices: A review of the literature

Abstract

Totally implantable venous access devices, or ports, are essential in the therapeutic management of patients who require long-term intermittent intravenous therapy. Totally implantable venous access devices guarantee safe infusion of chemotherapy, blood transfusion, parenteral nutrition, as well as repeated blood samples. Minimizing the need for frequent vascular access, totally implantable venous access devices also improve the patient's quality of life. Nonetheless, totally implantable venous access devices are not free from complications. Among those, infection is the most relevant, affecting patients' morbidity and mortality-both in the hospital or outpatient setting-and increasing healthcare costs. Knowledge of pathogenesis and risk factors of totally implantable venous access device-related infections is crucial to prevent this condition by adopting proper insertion bundles and maintenance bundles based on the best available evidence. Early diagnosis and prompt treatment of infection are of paramount importance. As a totally implantable venous access device-related infection occurs, device removal or a conservative approach should be chosen in treating this complication. For both prevention and therapy, antimicrobial lock is a major matter of controversy and a promising field for future clinical studies. This article reviews current evidences in terms of epidemiology, pathogenesis and risk factors, diagnosis, prevention, and treatment of totally implantable venous access device-related infections.

Comparison of PICC and TIVAP in chemotherapy for patients with thyroid cancer

“…However, the failure of PICC leads to poor experience, including stabbing pain and increase in hospital stay, equipment cost and work (19). TIVAP is a widely used intermittent central venous access, especially suitable for patients with cancers, and its ports have higher safety margin compared with other long-term venous access devices (20). It is generally used for patients who require long-term or repeated treatment, such as antitumor chemotherapy, parenteral nutrition and blood transfusion.…”

Minimising Blood Stream Infection: Developing New Materials for Intravascular Catheters

“…It is of little surprise therefore that tunnelled CVCs and TIVAPs which are intended for long term use (typically months to years) dominate the CRBSI literature. While TIVAPs are primarily designed for periodic/infrequent applications (i.e., haemodialysis) [22], tunnelled CVCs are generally targeted at those interventions where regular administration of fluids, medication, parenteral nutrition or the aspiration of blood is Selection of the catheter system is invariably based on patient-specific factors such as: purpose, anticipated lifetime and the frequency with which the catheter will need to be accessed. It can be anticipated that the longer the catheter is in place, the greater the risk of infection.…”

“…It is of little surprise therefore that tunnelled CVCs and TIVAPs which are intended for long term use (typically months to years) dominate the CRBSI literature. While TIVAPs are primarily designed for periodic/infrequent applications (i.e., haemodialysis) [22], tunnelled CVCs are generally targeted at those interventions where regular administration of fluids, medication, parenteral nutrition or the aspiration of blood is required. As such, the frequency with which the needle free connector (NFC) is manipulated can be particularly problematic with the majority of the infections arising as a consequence of its contamination [23,24].…”

Chinese expert consensus and practice guideline of totally implantable access port for digestive tract carcinomas

“…The time interval between the port implantation and first medication may be a risk factor for the occurrence of port-related infections[ 28 ]. The results of a prospective cohort study showed that when the intervals between the catheter implantation and first medication were 0-3 d, 4-7 d, and > 7 d, the total incidence rates of complications were 24.4%, 17.1%, and 12.1%, respectively, and the incidence rates of infections were 10.6%, 6.7%, and 2.0%, respectively[ 29 ].…”