Patients’ perceptions of having a central venous catheter or a totally implantable subcutaneous port system–results from a randomised study in acute leukaemia
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Goals of work
The selection process of type of central venous access device (CVAD) in patients with acute leukaemia (AL) is generally based on appropriate catheter capacity/function and risk of complications in relation to the planned length of therapy. Advantages and disadvantages of the CVAD from the patient’s perspective should also be important parts in the selection of type of device. Perceptions on having a CVAD were thus analysed in a series of adult patients with AL included in a prospective randomised study evaluating the use of a double lumen totally implantable subcutaneous port system (PORT) or a double lumen central venous catheter (CVC) regarding survival time and complication rate.
Materials and methods
Perceptions were registered in 32 patients (median age 68 years, range 24–83 years) on three occasions (T1; the day after placement, T2; 3 weeks after placement and T3 after 12 weeks and/or when the CVAD was removed) with the use of two study specific questionnaires.
Overall, many patients reported minor catheter related discomfort, feelings of anxiety and restrictions. Half of the patients (6/11) who experienced a local bleeding after CVAD insertion described the placement procedure as unpleasant. More patients in the CVC group compared with the PORT group stated that they thought of having a CVAD (T3; p = 0.02) and that the CVAD interfered when dressing themselves (T2; p = 0.02 and T3; 0.04) or taking a shower (T3; p = 0.009).
Our findings support the view that the PORT is less restrictive in daily life than the CVC.
KeywordsCentral venous catheter Implantable subcutaneous port system Acute leukaemia Randomised Patient satisfaction
This study was supported by grants from the Swedish Cancer Society, and the Stockholm County Council. The authors wish to thank Jan Jacobson, Peter Löthman, Rabbe Takolander, Per Olofsson, Lars Backman, Eddie Weitzberg, anaesthesiologists and surgeons, inserting CVADs in this study.
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