The case for using implanted ports

Uses of central venous access devices (CVADs) include the administration of vital fluids and medications. Implanted ports are a type of CVAD that is used when long-term vascular access is required. The device is discreet and associated with a low risk of catheter-related bloodstream infection. This article describes the different types and components of ports and how to select them. It explains how to insert ports, and provides guidance on accessing and de-accessing them

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Advanced vascular access

Paediatric Anaesthesia ◽

10.1093/med/9780198755791.003.0010 ◽

2019 ◽

pp. 177-190

Author(s):

Richard Craig

Keyword(s):

Vascular Access ◽

Central Venous Access ◽

Venous Access ◽

Central Venous ◽

Short Term ◽

Central Lines ◽

Venous Access Devices

In this chapter, the use of ultrasound to facilitate cannulation of a vessel is described in detail, including commentaries on equipment, preparation, scanning, and needling technique. Equipment and techniques for the insertion of short-term non-tunnelled central lines, long-term central venous access devices, arterial lines, and intraosseous needles are presented.

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A narrative review of long-term central venous access devices for the intensivist

Journal of the Intensive Care Society ◽

10.1177/1751143717741249 ◽

2017 ◽

Vol 19 (3) ◽

pp. 236-246 ◽

Cited By ~ 1

Author(s):

David Moir ◽

Andrew Bodenham

Keyword(s):

Central Venous Access ◽

Venous Access ◽

Narrative Review ◽

Potential Utility ◽

Central Venous ◽

Different Types ◽

Venous Access Devices

Long-term central venous access devices are increasingly prevalent and consequently often encountered by intensivists. This review introduces the different types of long-term central venous access devices, outlines their potential utility, examines potential complications associated with their use and outlines an approach to the management of these complications.

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Prevention of Infection in Adults Receiving Intravenous Antibiotic Treatment via Indwelling Central Venous Access Devices

Reviews on Recent Clinical Trials ◽

10.2174/1574887113666180817125036 ◽

2019 ◽

Vol 14 (1) ◽

pp. 47-49

Author(s):

Basant K. Puri ◽

Anne Derham ◽

Jean A. Monro

Keyword(s):

Bloodstream Infection ◽

Antibiotic Treatment ◽

Central Venous Access ◽

Case Series ◽

Bloodstream Infections ◽

Venous Access ◽

Host Cells ◽

Central Venous ◽

Intravenous Antibiotic ◽

Venous Access Devices

Background: The use of indwelling Central Venous Access Devices (CVADs) is associated with the development of bloodstream infections. When CVADs are used to administer systemic antibiotics, particularly second- or higher-generation cephalosporins, there is a particular risk of developing Clostridium difficile infection. The overall bloodstream infection rate is estimated to be around 1.74 per 1000 Central Venous Catheter (CVC)-days. Objective: We hypothesised that daily oral administration of the anion-binding resin colestyramine (cholestyramine) would help prevent infections in those receiving intravenous antibiotic treatment via CVADs. Method: A small case series is described of adult patients who received regular intravenous antibiotic treatment (ceftriaxone, daptomycin or vancomycin) for up to 40 weeks via indwelling CVADs; this represented a total of 357 CVC-days. In addition to following well-established strategies to prevent C. difficile infection, during the course of the intravenous antibiotic treatment the patients also received daily oral supplementation with 4 g colestyramine. Results: There were no untoward infectious events. In particular, none of the patients developed any symptoms or signs of C. difficile infection, whereas approximately one case of a bloodstream infection would have been expected. Conclusion: It is suggested that oral colestyramine supplementation may help prevent such infection through its ability to bind C. difficile toxin A (TcdA) and C. difficile toxin B (TcdB); these toxins are able to gain entry into host cells through receptor-mediated endocytosis, while anti-toxin antibody responses to TcdA and TcdB have been shown to induce protection against C. difficile infection sequelae.

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Tip Position of Long-Term Central Venous Access Devices Used for Parenteral Nutrition

Journal of Parenteral and Enteral Nutrition ◽

10.1177/0148607107031005382 ◽

2007 ◽

Vol 31 (5) ◽

pp. 382-387 ◽

Cited By ~ 32

Author(s):

Robert DeChicco ◽

Douglas L. Seidner ◽

Carlos Brun ◽

Ezra Steiger ◽

Judy Stafford ◽

...

Keyword(s):

Parenteral Nutrition ◽

Central Venous Access ◽

Venous Access ◽

Central Venous ◽

Tip Position ◽

Venous Access Devices

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Venous Access

Interventional Radiology ◽

10.1093/med/9780190276249.003.0016 ◽

2018 ◽

pp. 173-181

Author(s):

Mary E. Meek

Keyword(s):

Central Venous Access ◽

Venous Access ◽

Brand Names ◽

Treatment Team ◽

Central Venous ◽

Interventional Radiologist ◽

Different Types

This chapter reviews the characteristics of various types of central venous access catheters, infusaports, and peripherally inserted catheters frequently used in hospitals today. Temporary and long-term dialysis catheters are reviewed as well. Many different types of catheters and devices exist, and the nomenclature can be confusing. Devices are described by their size, materials, number of lumens, type of tips, the presence or absence of a cuff, and occasionally, by brand names. An in-depth understanding of the indications for placement, duration of expected use, and patient comorbidities will allow the interventional radiologist to choose the best device for the patient and treatment team.

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