Infusion ports were associated with low rates of complications in pediatric patients with sickle cell disease (SCD), according to a new study published in Pediatric Blood & Cancer.
A total of 32 patients received 63 infusion ports with a median catheter lifespan of 1340 days. During this time, rates of adverse events were low including 0.36 per 1000 catheter days for infusion port malfunction, 0.2 per 1000 days for infection, and 0.03 per 1000 days for thrombosis.
Ports were placed for patients who received chronic transfusions (CT, 48 ports placed in 23 patients) as well as those who had poor venous access (PVA, 15 ports placed in 9 patients). Of those catheters placed for CT, patients required infusions for primary (n=6) or secondary (n=22) stroke prophylaxis, recurrent vaso-occlusive events (RCE, n=17), or multiorgan failure (n=3).
“We report that use of infusion ports in the pediatric sickle cell patient population was not associated with a significantly higher rate of thrombosis, infection, or premature removal,” the authors said.
“Infusion ports offer an effective and reliable solution especially in the subset of children with PVA or those requiring access for CT or RCE.”
A total of 54 complications related to infusion ports were reported during the study, resulting in the removal of 36 ports. Infusion port malfunctions occurred in 29 cases and resulted in the removal of the port in all instances.
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A total of 20 bloodstream infections were reported but these were effectively treated with antibiotics and only resulted in the removal of 3 infusion ports. Thrombosis occurred in 3 out of the 32 patients resulting in the removal of 2 ports due to lack of response from anticoagulant treatment.
The overall rate of complications for patients was found to be 0.52 per 1000 catheter days for patients receiving CT, and 0.63 per 1000 days for the rest of the patients. These rates were not significantly different (P =.60). The rates of complications were also not significantly different between patients receiving splenectomy or not (P =.64) or those who had their infusion ports placed in the right subclavian vein or left subclavian vein (P =1).
However, age was found to be a significant factor in the length of time that patients had their catheters (P =.03). Older patients tended to have their catheters for shorter lengths of time. The authors suggested this may be due to a higher rate of complications in older patients.
Reference
Ilonze C, Anderson M, Stubblefield A, Journeycake J, Sinha AA. Use of infusion ports in patients with sickle cell disease: indications and complications. Pediatr Blood Cancer. Published online November 16, 2021. doi:10.1002/pbc.29445
