Lesson of the Week: Retention of drugs in venous access port chamber: a note of caution

doi:10.1136/bmj.312.7029.496

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Myriam Ben-Arush, director of paediatric oncologya,
Moshe Berant, professor of paediatricsa

^a Rambam Medical Center and Technion-Faculty of Medicine, Haifa 31096, Israel

Correspondence to: Professor Berant.

Accepted 20 August 1995

Indwelling tunnelled central venous catheters are widely used for venous access in patients who require intravenous nutrition, fluids, antibiotics, chemotherapy, and other drugs for protracted periods.1 2 Maintaining these central venous catheters warrants meticulous adherence to protocol, which includes adequately flushing after drug administration and leaving a heparin lock for preventing blockages, rigorous care of the catheter exit site on the skin, and, most important, strict observation of aseptic techniques when handling the external tubing so as to minimise the risk of infection, which is the main complication of long use intravenous catheters.3 4

Failure immediately to flush a port venous access device after delivery of drugs can have grave consequences

The advent of completely implanted subcutaneous port systems5 has simplified long term venous access and also appears to have reduced significantly the risk of infection.1 6 Central venous placement of port linked catheters is similar to that of external catheters, but the venous catheter of a port system, instead of exiting through the skin, is attached to a reservoir within a port …