Complications of PORT-A-CATH in patients with sickle cell disease

ABSTRACT

Red cell exchange/transfusion is frequently used in the management of patients with medical complications related to acute severe sickle cell disease [SCD]. However, peripheral venous access is often difficult without central venous catheters [CVCs] in adult patients with moderate or severe SCD. To review our experience with the use of the PORT-A-CATH device in sixteen patients with SCD undergoing exchange or simple transfusions. Among a cohort of 550 patients who frequently visited the inpatient service, sixteen SCD patients required the insertion of a PORT-A-CATH device. These patients included 3 males and 13 females, aged 25-44years [31.1 +/- 2.3; mean +/- [SD]. A total of 24 PORT-A-CATH devices were implanted in these 16 patients during the study period. Eleven patients had 1 device implanted, three patients had 2 devices, one patient had 3 devices, and one patient had 4 devices implanted. Out of the 24 devices implanted, 17 required removal, due to either infection associated with sepsis and/or thrombosis. The organisms involved were Candida spp. [3], C. Parapsilosis [2], C. albicans [1], C. famata [1], C. lusitanice [1], Staphylococcus spp. [6], and S. aureus [3], as well as the coagulase-negative Staphylococcus [2], alpha hemolytic Streptococcus [1], Diphtheroidbacilli [2], Pseudomonas aeruginosa [2], Ps. Spp. [3], Escherichia coli [3], Klebsiella oxytoca [1], Klebsiella pneumoniae [1], Klebsiella spp. [1], Serratia liquefaciens [1], Serra-tia fanticola [1], Achromobacter spp. [2] Chromobacterium violaceum [1], Delftia acidovirans [1], Stenotrophomonas maltophile [1], Alcaligenes faecalis [1], and Enterobacter cloacae [1]. Two episodes of documented thrombosis were observed