Long-term intravenous therapy with use of peripherally inserted silicone-elastomer catheters in orthopaedic patients. 1995

J W Parker, and R W Gaines
Division of Orthopaedic Surgery, University of Missouri Hospitals and Clinics, Columbia 65212, USA.

We studied the results of prolonged intravenous therapy with antibiotics through a central venous silicone-elastomer catheter that had been peripherally inserted in thirty-five orthopaedic patients. The catheters remained in place for an average of twenty-nine days (range, five to seventy-four days). The 20-gauge (one-millimeter-diameter) catheters used in our study were smaller in diameter than the triple-lumen catheters or the double-lumen Hickman catheters used in previous studies. The catheters in our study were left indwelling for as long as, or for longer than, those in other studies. Our patients had no serious complications related to the insertion or use of the catheter. However, three (8 per cent) of thirty-eight inserted catheters failed mechanically and had to be removed. Two additional catheters (5 per cent) were removed because the lumen became plugged. One catheter in each of these groups was not replaced, because a catheter was no longer necessary. We believe that the problems with the catheters were related to the small diameter of the tubing that was used in our series. Use of the small-diameter catheter reduces the risk of cardiac tamponade and other complications associated with catheters that have larger diameters, and small-diameter catheters can remain indwelling for a long time. The peripheral route of insertion eliminates the risk of pneumothorax associated with the subclavian route of placement and allows for greater ease of insertion. In addition, the use of catheters made of silicone elastomer reduces the risk of thrombosis and infection, which are associated with catheters made of polyethylene.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010019 Osteomyelitis INFLAMMATION of the bone as a result of infection. It may be caused by a variety of infectious agents, especially pyogenic (PUS - producing) BACTERIA. Osteomyelitides
D002405 Catheterization, Central Venous Placement of an intravenous CATHETER in the subclavian, jugular, or other central vein. Central Venous Catheterization,Venous Catheterization, Central,Catheterization, Central,Central Catheterization,Catheterizations, Central,Catheterizations, Central Venous,Central Catheterizations,Central Venous Catheterizations,Venous Catheterizations, Central
D002408 Catheters, Indwelling Catheters designed to be left within an organ or passage for an extended period of time. Implantable Catheters,In-Dwelling Catheters,Catheter, In-Dwelling,Catheter, Indwelling,Catheters, In-Dwelling,In Dwelling Catheters,In-Dwelling Catheter,Indwelling Catheter,Indwelling Catheters
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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