USE OF SUBCUTANEOUS IMPLANTABLE INFUSION SYSTEMS IN NEOPLASTIC AND AIDS PATIENTS REQUIRING LONG-TERM VENOUS ACCESS

Objective. To evaluate the life span and complication rates of totally implantable infusion devices in patients with short bowel syndrome an d in immunocompromised patients with AIDS, lymphoma, and myeloma who r equired long term central venous access. Design: Prospective open stud y. Setting: University hospital, Italy. Subjects: Group I - 5 patients with short bowel syndrome; group II - 11 patients with AIDS; and grou p III - 15 patients with lymphoma or multiple myeloma (1 of whom had 2 devices implanted). Main outcome measures: Duration of implantation a nd incidence of catheter-related complications. Results: The mean dura tion/patient of the catheter was 422 days (range 20-1257) in group I; 104 days (range 43-262) in group II; and 415 days (range 62-1280) in g roup III. There were no catheter related complications in the patients in group I (short bowel syndrome). Of the 11 patients with AIDS (grou p II) 4 developed catheter related infections (0.32/100 catheter days) , and 1 developed a thrombotic occlusion. All 5 catheters were removed (3 for infection). Of the 15 patients with lymphoma or myeloma who ha d 16 catheters implanted (group III), 1 patient developed 3 infective episodes (0.05/100 catheter days), 1 catheter migrated and 1 occluded. All 3 catheters were removed. Conclusion: Totally implantable infusio n systems can safely be used for prolonged periods in immunocompromise d patients, including those with AIDS if their life expectancy is reas onable.