Totally implantable venous access system gained widespread use and acceptance in the management of children with cancer in whom frequent and prolonged venous access is required for chemotherapeutic agents, intravenous fluids, antibiotics, blood
products, total parenteral nutrition and blood sampling. We analyzed our early experiences of insertion and use of totally implantable venous access device(TIVAD) in 20 pediatric oncology patients(24 devices), between October 1990 and December
1991.
Median age of patients was 3 years and 3 months old. Median duration of utilization was 00 days(range 2-574 days). Access vein was left jugular(60.9%). Right jugular (13.1%), left cephalic(21.7%), and right cephalic vein(4.3%). Insertion
complication
rate was 8.3%. Five systems(20.8%) were removed due to complication. Complication rate for infection was 25.0%. There was twenty three times of catheter occlusion and two catheters were completely occluded. Most of catheter occlusions were by the
fibrin
clot and relieved by urokinase irrigation. All the catheters with their tip located in SVC, experienced occlusion of catheter. The major problems in using TIVAD were infection and catheter occlusion, so further efforts required to reduce
infection
and
catheter occlusion.
|