Description & Benefits & Care Considerations

Description Benefits Care Considerations
Tunneled Catheter (e.g., Hickman or Broviac Catheter)
Silicone, radiopaque, flexible catheter with open ends or VitaCuffs (biosynthetic material impregnated with silver ions) on catheter(s) enhances tissue ingrowth

May have more than one lumen

Reduced risk for bacterial migration after tissue adheres to cuff

Easy to use for self-administered infusions

Removal requires pulling catheter from site (nonsurgical procedure)

Requires daily heparin flushes

Must be clamped or have clamp nearby at all times

Must keep exit site dry

Heavy activity restricted until tissue adheres to cuff

Water sports may be restricted (risk for infection)

Risk for infection still present

Protrudes outside body; susceptible to damage from sharp instruments and may be pulled out; may affect

body image

More difficult to repair

Patient or family must learn catheter care

Groshong Catheter
Clear, flexible, silicone, radiopaque catheter with closed tip and two-way valve at proximal end

Dacron cuff or VitaCuff on catheter enhances tissue ingrowth

May have more than one lumen

Reduced time and cost for maintenance care; no heparin flushes needed

Reduced catheter damage; no clamping needed because of two-way valve

Increased patient safety because of minimal potential for blood backflow or air embolism

Reduced risk for bacterial migration after tissue adheres to cuff

Easily repaired

Easy to use for self-administered IV infusions

Requires weekly irrigation with normal saline

Must keep exit site dry

Heavy activity restricted until tissue adheres to cuff

Water sports may be restricted (risk for infection)

Risk for infection still present

Protrudes outside body; susceptible to damage from sharp instruments and may be pulled out; can affect body image

Patient or family must learn catheter care

Implanted Ports (e.g., Port-A-Cath, Infus-A-Port, Mediport, Norport, Groshong Port)
Totally implantable metal or plastic device that consists of self-sealing injection port with top or side access with preconnected or attachable silicone catheter that is placed in large blood vessel Reduced risk for infection

Placed completely under the skin and therefore much less likely to be pulled out or damaged

No maintenance care and reduced cost for family

Heparinized monthly and after each infusion to maintain patency (only Groshong port

requires saline)

No limitations on regular physical activity, including swimming

Dressing needed only when port accessed with Huber needle that is not removed

No or only slight change in body appearance (slight bulge on chest)

Must pierce skin for access; pain with insertion of needle; can use local anesthetic (EMLA, LMX) or intradermal buffered lidocaine before accessing port

Special noncoring needle (Huber) with straight or angled design must be used to inject into port

Skin preparation needed before injection

Difficult to manipulate for self-administered infusions

Catheter may dislodge from port, especially if child “plays” with port site (twiddler syndrome)

Vigorous contact sports generally not allowed

Removal requires surgical procedure

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