Comparison of three types of central venous catheters in patients with malignant tumor receiving chemotherapy

Abstract

BackgroundCentral venous catheters (CVCs) have been an effective access for chemotherapy instead of peripherally intravenous catheters. There were limited studies on the choices and effects of different types of CVCs for chemotherapy. The aim of this study was to compare the complications, cost, and patients’ quality of life and satisfaction of three commonly used CVCs for chemotherapy, such as implanted venous port, peripherally inserted central catheters (PICCs), and external non-tunneled central venous catheters (NTCs).MethodsA double-center prospective cohort study was carried out from March 2014 to December 2016. Catheterization situation, complications, catheter maintenance, cost, and patients’ quality of life and satisfaction were recorded, investigated, and analyzed. Forty-five ports, 60 PICCs and 40 NTCs were included. All the CVCs were followed up to catheter removal.ResultsThere was no statistical difference in catheterization success rates between port and PICC. NTC had less success rate by one puncture compared with port. Ports had fewer complications compared with PICCs and NTCs. The complication rates of ports, PICCs and NTCs were 2.2%, 40%, and 27.5%, respectively. If the chemotherapy process was <12 months, NTCs cost least, and the cost of port was much higher than PICC and NTC. When the duration time was longer than 12 months, the cost of port had no difference with the cost of PICC. Quality of life and patients’ satisfaction of port group were significantly higher than the other two groups.ConclusionAlthough port catheterization costs more and needs professional medical staff and strict operational conditions, ports have fewer complications and higher quality of life and patients’ satisfaction than PICCs and NTCs. Therefore, not following consideration of the economic factor, we recommend port as a safe and an effective chemotherapy access for cancer patients, especially for whom needing long chemotherapy process.

Risk of venous thromboembolism associated with totally implantable venous access ports in cancer patients: A systematic review and meta‐analysis

“…81,83,90 In eight studies, 80,[82][83][84][86][87][88]90 clinical signs prompted ultrasonic or radiological testing to diagnose VTE; the other three studies did not report the trigger for VTE testing. 81,85,89 VTEs were diagnosed by venography in two studies, 82,88 ultrasound in four, 80,83,84,86 and various methods (venography, CT, and magnetic resonance imaging) in two. 87,90 Two studies noted use of anticoagulant prophylaxis.…”

Vascular access considerations for extracorporeal photopheresis

“…An aspect of IVAD that is often overlooked and rarely evaluated is the effect of the device on the patient's quality of life. Studies show that patients who have port‐CVCs report a higher quality of life when compared to patients with TCVCs . Port‐CVCs are completely localized under the skin, which allows patients to bathe and swim without the need for occlusive dressings.…”

“…Studies show that patients who have port-CVCs report a higher quality of life when compared to patients with TCVCs. 43,44 Port-CVCs are completely localized under the skin, which allows patients to bathe and swim without the need for occlusive dressings. Maintenance of port-CVCs with monthly line flushes is simpler than that for TCVCs, which require regular dressing changes and weekly line flushes.…”

Focusing on the hospital stay or everyday life with cancer: Parents’ experiences of choosing a central access device for their child with cancer

“…Several complications, such as infections, can be associated with the insertion of a central access device (Moell et al, ). Patients with an SVP have fewer complications than patients with a CVC (Coady, Ali, Sidloff, Kenningham, & Ahmed, ; Fang, Yang, Song, Jiang, & Liu, ) and also report a higher quality of life than those with a CVC (Fang et al, ). By contrast, Flynn, Willis, Gaur, and Shenep () showed that there is a greater risk of recurring catheter‐related infections with an SVP than with a CVC.…”