Has anyone got a portacath or central line?

[Duggee]

Could you tell me your experiences and how hard they are to keep clean and infection free. Thank you.

Hi Duggee, my daughter has leukaemia and has a central line. In general I've found it easy to maintain. This is her second one, however we had problems with her first one. It was faulty and despite being repaired, it had to be removed and replaced. We've had a couple of line infections, and they're not unusual. It's a godsend in terms of administering medication. I spent months doing daily IV meds so it saved us a lot of time that would have to have been spent in hospital. The maintenance is easy once you get into a routine. If you have any specific questions I'd be happy to help if I can. Good luck with the treatment!

Ds1 had 2 portacaths in 2 different sites over about 3 .5 years while having cancer treatment. We didn't do anything in particular to keep it clean, other than usual washing in the bath and he never had any infections. He very rarely needed to have it left accessed if he wasn't in hospital having treatment so it was very easy to forget about it.

My son had a portacath during treatment... he had it accessed for 5 days at a time. When it was accessed then at bath time we would cover it with plastic and tape the skin with medical tape for sensitive skin. When he didn't have it accessed he had his bath as usual. I do know someone whose little girl developed septicaemia from an infection in her portacath. She was seriously ill but thankfully pulled through.

Hi Dugee,

I don't have a child who has either but I am a paeds nurse in the community. It really does depend on what it's being used for/how often it is being accessed/ how long it needs to be in for and other lifestyle factors to consider e.g. Age, activity (you can go swimming with a port

Thanks for your replies. A nurse suggested it to us as my little boy is often in hospital but has ivs placed, and has regular blood tests too. Infection is the thing I worry about. Why are central lines etc used instead of placing cannulas, is it just to avoid distress or are there other reasons?

It's for ease of access. Our son was having 30 sessions of radiation under general anaesthesia each time - over the course of 6 weeks. If he didn't have the port - they would have had to put a cannula in 30 times if he didn't have the port (plus all the times he needed blood tests etc).

Yes it is ease of access. There are a finite number of times that a vein can be cannulated so a port or central line bypasses this. There is care involved for both types of line (port needs regular flushing as does central line which also needs dressing changes).

I would say without knowing any of the details of your sons condition that a port is a good long term option. They last years and allow a child to live a pretty normal life. A central line needs a bit more care, esp with infection control but is easier to access (no needles) and large amounts of drugs can pass through it, so a good shorter term option.

HTH

My nearly 7 year old has a port. We were given the choice of a port or a central line but managed to convince DS that a port would mean he could continue to enjoy the things he loves ( deep bubble baths, water rides at theme parks, swimming etc!) it does obviously mean it needs to be accessed, but it's been in now for 7 weeks and he's doing ok, still a little jittery in the run up to access but then always says it didn't hurt!

We've had no problems at all with infection. This was one of our reasons for wanting DS to have a port

Is he going to be having regular three monthly IV's?

I think, from your terminology, that your DS has the same condition as one of my DC.

I am surprised they have recommended a central line - it's not common to have a central line in my DC's case, but portacaths are extremely common and are placed under the skin. Central lines tend to be for patients who will be in hospital care for a while (or at least from my experience).

Infection rate is low due to being placed under the skin, but obviously they will advise on infection risk when a gripper is in situ, as when it's accessed the infection risk increases.

One of my DC has had a central (when they were a long term inpatient) and has had two portacaths - They are ideal for regular IV use. If your son is going to be having regular IV's then cannulas are best avoided as it puts unnecessary pressure on the veins - they become more difficult to access when having regular antibiotics.

I would really recommend a portacath in situations like ours - I have advised other parents both the reasons for and against but mainly advocate that I agree that they are so much more convenient.

Also your son may be compliant with cannulas at the moment but this may change if his veins become more difficult and placing cannulas is a more traumatic experience.

Dd2 is probably going to have a Portacath at her next admission. She has had IVs three times in the last year and as I understand there is a limited number of times they can use picc lines in a childs veins and still be successful.
Her doctors put it to me that it just makes everything less traumatic - no canulas or long lines to worry about, no more needles as normally blood can be taken through the port as well. It has to be flushed and checked every month and I presume they would talk to you about checking for early signs of infection.

Thanks. My boy is neutropenic and more than likely will be for another year. He's been in hospital x4 with 5 cannulas placed in that time and countless blood tests! One time they were using his wrist for blood as they couldn't access his hands or feet is it painful to have blood taken from a portacath?

It's very hard watching them go through this. My son's port is out now as his treatment is finished, but he still has regular tests etc. It makes me panic worrying whether a cannula will allow blood to be drawn - knowing the nurses will just have to start over if it doesn't...which has happened a load of times.

Drawing blood from a port is straight forward. Before the port is accessed, numbing cream is applied. Once it is accessed, drawing blood is pretty much the same as from a regular cannula.

We had the choice of a port/hickman line. I would make the same choice again.

My DS has had his port for nearly 6 years now! It's normally accessed every other day (bleeding disorder treatment). In the past few months it's been a couple of times a week as we use butterfly needles in veins now that they're bigger.
We've never had an infection/blockage. There have been occasions when we've had to leave a gripper in for daily treatment, but the longest we've left it is a week. We used numbing cream up until about 2 years ago, but now he doesn't need it as we're just accessing over scar tissue so it's not so painful.

We have drawn blood from it - easy. As long as it's used/flushed a couple of times a week, and you make sure everything is kept clean and uncontaminated when accessing, it's fine. We were taught the sterile technique, so basically our procedure is as clean as a surgical environment. Some people use aseptic no touch technique - where you don't need sterile gloves etc, but I've never trusted it. Like I said, in nearly 6 years we've had no infections so sterile has worked for us.

Good luck with everything :-)

We had 2 Femoral lines and a Jugular Hickman line all at the same time and left in for 2 months (femoral) and 6 months (Hickman). (newborn in NICU waiting for organ transplant, lots of medications and collapsing veins). One of the Femoral ones kept getting infected but the other 2 were always fine.

The Hickman line always really terrified me as I was so worried about it getting pulled, but it was always ok thankfully.