Our world has been advancing in terms of science and technology at speeds 10 times faster than it did in the times of our great-grandfathers and though some may argue that it may be harmful for humans, we beg to differ, as continuous research and findings in science, particularly the medicinal branch is proving to save millions of life. An example of technological advance in recent times is creation of Chemoport.
What is a Chemo Port?
Chemo Port is a disc shaped device made either out of plastic or steel, depending on the type your doctor deems suitable for you, that is inserted inside a large vein situated in our upper chest such as the subclavian vein or the jugular vein.
In some rare cases it’s installed in the upper arm as well. Doctors give local anesthesia before they perform the surgery. The surgery is most often recommended a week before the chemo session kick starts.
The disc is further connected to a silicon tube that helps inject chemotherapy medications directly into the patient’s vein through the port. Thereby, it does away with the need of using needles to do the job, as used to be the case before they came to be used so widely.
What is a Central Venous Access Device?
It is a catheter that is inserted into the venous system with the tip being in the central vein. Central veins include-
- Superior vena cava
- Inferior vena cava
- Brachiocephalic veins
- Internal jugular veins
- Subclavian veins
- Iliac veins
- Common femoral veins
What are the various types of Central Venous Access Devices?
CENTRAL VENOUS CATHETER
- CENTRAL CATHETER – IJV, SCV, FV
TUNNELED – Reduce the incidence of infection by increasing the distance between the skin entry site and the venotomy
What are the parts of a Chemoport?
Chemoport consists of a catheter attached to a reservoir that is implanted into a surgically created pocket on the chest wall or upper arm.
A Huber needle is inserted through the port’s septum to access the reservoir.
A port diaphragm can be punctured 1000 to 2000 times
When is a chemo port used? What are the indications of chemoport insertion?
As the name suggests chemo ports are used during chemotherapy sessions of cancer patients to deliver IV fluid, medicines and to extract samples of blood samples to conducts tests. Chemo ports are used by doctors for patients who are anxious of needles. It is also used for kids for easy deliverance and extraction of blood samples.
There are some specific indications for chemoport insertion. They are as follows-
- Limited vascular access
- Administration of highly osmotic or caustic fluids or medications
- Frequent administration of blood and blood products
- Frequent blood sampling
- Measurement of CVP
When should a Chemoport not be used? What are the containdications of Chemoport Insertion?
- Distorted Anatomy
- Infection at the site of access
- Proximal Vascular Injury
- Bleeding Disorders
- Hypercoagulable state
What are the Indications of Chemoport removal?
- Severe sepsis
- Suppurative (septic) thrombophlebitis
- Tunnel infection
- Port abscess
- Blood Stream Infections which continues despite 48–72 h of adequate coverage
- Infections with S. aureus, pseudomonas, fungi or mycobacteria
What are the benefits of using a Chemo Port?
Chemo Port is the new buzz in the town and for all the right reasons. Using the Chemo Port instead of a needle has its advantages.
- The port is prepared in a sterile fashion, therefore there’s a reduced risk of infection.
- The port also requires less time to deliver the medicine as it skips the need to find the right vein and then prepare your arm and hand for the infusion.
- There are less chances for bruising as ports make it less likely for the medication to leak into surrounding tissue and thereby causing inflammation.
- A single port can be used over several days to inject the medication that means the port stays in patient’s chest for as long as the chemo lasts.
- The port can also be used to inject other various fluids and draw blood for lab testing, thereby serving to be multi-purpose.
- For patients that are phobic to needles, it performs as a great alternative that is relatively less painful.
- Patients can easily bathe as the device is completely covered with skin, thereby reduces any risks related to infection.
However, all things come with a set of advantages and disadvantages.
What are the complications of Chemoport Insertion?
- Arrythmia (15-25%)
- Arterial puncture (0-15%) (FV >IJV >SCV)
- Catheter malpositioning (5-15 %)
- Pneumothorax (2-3%) /hemothorax (0.1-11%)
- Air embolism (rare)
- Thoracic duct injury (rare with left sided SCV)
- Venous thrombosis, pulmonary embolism
- Catheter migration
- Catheter embolism
- Myocardial injury, perforation
- Nerve injury
- Compression of a catheter at the costoclavicular space as it passes between the clavicle and first rib
- Can lead to catheter fracture, breakage, extravasation and catheter embolism
Flushing of Chemoport
Chemoport flushing is done by S-A-S (Saline – Administration – Saline) technique. It is done with 5-10 mL of 0.9% normal saline after each access and every month. For blood product transfusion, 5 to10 mL of NS before and10-20mL of NS after transfusion should be given. For blood sampling, initially discard a volume of 5mL and give 10-20 mL NS after sampling.
What are the disadvantages of Chemoport?
Although benefits of using ports seem to be greater than its disadvantages, there are still major risks associated with their use, as listed below
- The outpatient surgery required to install the port may carry risks of puncturing nearby veins or causing pneumothorax.
- Although this risk may be lower than the rest, it still pops up in a few rare cases, it’s when the port installed becomes infected in which case it needs to be removed and replaced.
- Thrombosis is another serious risk associated with the port, and it’s when a blood clot forms within the port, causing it to malfunction.
- Lastly, comes the scarring. The outpatient surgery performed on the patient leaves a scar on the patient’s chest that may also serve as a reminder of the disease.
- Physical exertion such as exercises involving movement of upper arms and chest would need to be avoided, as per doctor’s say, until the port is not removed.
But keep in mind that with right measures taken by oncologists a constant monitoring of the port the above-mentioned risks can be avoided.
When to visit a doctor (after port installation)
Now in case you fear that your port may be infected or that the medication has leaked into the surrounding tissue, you will need to look out for following signs that will serve as a warning system for you.
- The area around the port suddenly seems swollen and red coupled with a warm sensation
- The area around the port is experiencing pain
- The patient witnesses bleeding around the port
- The patient begins to feel lightheaded quite often
- The silicon tube begins to hang outside the body
In the above-mentioned circumstances, the patient should immediately contact or visit his or her oncologist and discuss the matter. In case the port has been infected or is leaking medication, it may need to be changed.
Removing the port
When the patient finally completes his chemo sessions, the doctor will remove the port. The procedure will require a minor surgery as the doctor will cut open the skin to extract the port and stitch it back again. But the patient needs not to worry, as doctors give local anesthesia or conscious sedation.
Author Bio: Kathleen Swafford passionate of internet stuff such as blogging, affiliate marketing and most. Currently working with Movies Jacket which provides best Joker Suit in good rates.