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 and in immunocompromised patients with AIDS, lymphoma, and myeloma who required long-term central venous access. DESIGN: Prospective open study. SETTING: University hospital, Italy. SUBJECTS: Group I - 5 patients with short bowel syndrome; group II - 11 patients with AIDS; and group III - 15 patients with lymphoma or multiple myeloma (1 of whom had 2 devices implanted). MAIN OUTCOME MEASURES: Duration of implantation and incidence of catheter-related complications. RESULTS: The mean duration/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 group III. There were no catheter related complications in the patients in group I (short bowel syndrome). Of the 11 patients with AIDS (group 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 had 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 infusion systems can safely be used for prolonged periods in immunocompromised patients, including those with AIDS if their life expectancy is reasonable.