Safety concerns related to use of unapproved needles for accessing implantable venous access devices

Powers, Michelle; Lublin, Douglas M.; Eby, Charles S.; Leitman, Susan F.; Dynis, Marian; Despotis, George J.

doi:10.1111/j.1537-2995.2009.02296.x

Cited by 3 publications

(3 citation statements)

References 1 publication

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“…The skin at the site of access must be disinfected with chlorhexidine solution or 70% alcohol and allowed to dry before access . The use of noncoring needles for access of IVAD ports is recommended to prevent damage to the septum and other complications, such as plastic emboli or blood extravasation . There are no clear recommendations regarding the length of time a needle can remain in place after access of the port or on the frequency of needle‐replacement needs.…”

Section: Catheter Maintenancementioning

confidence: 99%

Implanted vascular access device options: a focused review on safety and outcomes

Blanco-Guzman

2018

Transfusion

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Implantable vascular access devices are frequently used in patients who have poor peripheral venous access. These devices can be partially implanted as tunneled and nontunneled central catheters, or they can be fully implanted as ports. Compared with long-term catheters, implanted ports have lower infection rates and improved perceptions of quality of life, but complications still occur in 2% to 18% of patients, frequently requiring removal of the device. Since the conception of implantable vascular access device ports, numerous advances in port design, materials, and techniques for implantation and care have been developed with the goal of overcoming frequent complications. We review the evidence related to these advances and their effect on the safety profile and complications of implantable vascular access device ports. Since the first report of a fully implantable vascular access device (IVAD) in 1982, 1 the use of these devices has grown exponentially. They consist of a reservoir cradled in the subcutaneous tissue that is connected to a catheter, with its tip terminating into a major vein. IVADs are frequently used in patients who have poor peripheral venous access and are in need of long-term administration of vesicant drugs, antimicrobials, blood products, or parenteral nutrition.2,3 They also are used as access for long-term therapeutic apheresis procedures. 4 Although nonimplanted, long-term catheters can be used for all of these purposes as well, the lack of an external component in IVAD ports provides multiple advantages; patients have improved perceptions of quality of life and body image and less limitation in their mobility. 5 These ports also minimize the need for maintenance care and risk of infectious complications when the IVAD is not in use. 6 These benefits of IVAD port use have also been demonstrated in pediatric cancer patients, with the added advantage of allowing the child to participate in normal activities and preserving body image. 7Despite the vast experience accrued over the years and the large volume of literature studying factors associated with IVAD port outcomes, early perioperative and late postoperative complications still occur (see Table 1). 8,9 Overall complication rates for IVAD ports reportedly occur in the range from 2% to 18% of all implanted devices. 10-12Port-related infections and venous thrombosis are particularly important, because they are associated with additional morbidity and costs and require removal of the IVAD as part of their treatment in as many as 6.5% of patients. 10 An additional complication specific to the use of IVAD ports during therapeutic apheresis is the occurrence of frequent pressure-related alarms, 13-15 which do not always result in a need to abort the procedure but can delay the duration of the treatments and require additional interventions. 13Here, we present a review focused on techniques, materials, and long-term management options of ports as IVAD options that have an impact on the relevant complications and overall safety profile of th...

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Section: Catheter Maintenancementioning

confidence: 99%

Implanted vascular access device options: a focused review on safety and outcomes

Blanco-Guzman

2018

Transfusion

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“…The port's silicone septum can tolerate approximately 200 to 2000 repeated punctures with approved non‐coring 16‐gauge and 21‐gauge needles, respectively. If unapproved coring needles are used, however, then a markedly reduced port life is expected . Table lists the ports that are compatible with therapeutic apheresis and available in the United States.…”

Section: The Presentmentioning

confidence: 99%

“…If unapproved coring needles are used, however, then a markedly reduced port life is expected. 20,22,23 Table 2 lists the ports that are compatible with therapeutic apheresis and available in the United States.…”

Section: The Presentmentioning

confidence: 99%

Implantable vascular access devices – past, present, and future

Lin

2018

Transfusion

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Complications and Management Strategies of Totally Implantable Venous Access Devices

郭

2023

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Safety concerns related to use of unapproved needles for accessing implantable venous access devices

Cited by 3 publications

References 1 publication

Implanted vascular access device options: a focused review on safety and outcomes

Implanted vascular access device options: a focused review on safety and outcomes

Implantable vascular access devices – past, present, and future

Complications and Management Strategies of Totally Implantable Venous Access Devices

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