241 Totally implantable venous access devices (TIVAD), a survey at the Gothenburg CF-centre

Abstract

Objective: TIVAD has been used for many years at our CF centre for administration intravenously at home of antibiotics and nutritional solutions. The CF-team give individual information to the patient in need of a TIVAD, which is inserted in local or general anaesthesia. The device is inspected regularly and flushed with normal saline and heparin every one to three months. We avoid to use it for blood samples. We assessed the outcome of TIVADs; reasons for insertion, removal, lasting time and complications. Methods: Demographic and clinical data were extracted from the patient database and patient charts. There were 175 patients [53 (30%) <18 years] with a median age of 23 years (range 0−63) attending the Gothenburg CF-centre during 2013. Lung-transplanted patients (11/175) were excluded from analysis. Results: In total 49 patients (30% of the patient population) − 37 (33%) of the adults and 12 (23%) of the children − had or had previously had a TIVAD and 32 (65%) were females. The total number of TIVADs was 80 (1−5/patient) with a median time lasting of 4.8 (0.1–23.9) years by 31.12.2013. The first TIVAD was inserted at median of 12.5 years of age (range 0.5–38.6) and the major indication was repeated intravenous antibiotic treatments. Reasons for removal/change were infection, occlusion, venous thrombosis, catheter fracture, local trauma or local reaction, patient’s wish or no more need of the device. Three patients with thrombotic complications have new devices and anticoagulant therapy. Conclusion: TIVAD is a good and safe alternative for patients in need of frequent infusions. Complications occur and have to be checked for regularly by the CF nurse.