Complications of implantable venous access devices in patients with sickle cell disease.

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2011-10

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Abstract

Implantable venous access devices (VADs) are used in sickle cell disease (SCD) for patients with poor venous access to facilitate chronic blood transfusions and manage acute complications. We attempted to define the frequency of bloodstream infections (BSI) and thrombosis in adults and children with SCD and VADs. We performed a single-institution, retrospective review of VAD-associated infection and thrombosis in patients with SCD. Thirty-two patients (median age 20 years, range, 1-59) had 86 VADs placed (median, 2.7 VADs per patient, range, 1-7) with a total of 41,292 catheter days (median, 1,376 days; range, 323-3,999). Mean catheter lifespan in adults (691 days ± 123) was not significantly higher than children (614 days ± 154). A total of 66 VAD-associated BSI (1.59 infections per 1,000 catheter days) occurred in 17 of 32 (53%) patients. Children with VADs had fewer BSI (3 of 10; 30%) than adults (14 of 22; 64%, P = 0.08). 24 catheter-associated thromboses (0.49 thromboses per 1,000 catheter days) occurred in 10 of 32 (41%) of patients. Children also had fewer VAD-associated-thrombosis (1 of 10; 10%) than adults (9 of 22; 40%, P = 0.08). In conclusion, the use of VADs in SCD was linked to a significant rate of infection and thrombosis.

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10.1002/ajh.22230

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Shah, N, D Landi, R Shah, J Rothman, LM De Castro and CD Thornburg (2011). Complications of implantable venous access devices in patients with sickle cell disease. American journal of hematology, 87(2). pp. 224–226. 10.1002/ajh.22230 Retrieved from https://hdl.handle.net/10161/24076.

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Scholars@Duke

Shah

Nirmish Ramesh Shah

Associate Professor of Medicine
Landi

Daniel Bryce Landi

Assistant Professor of Pediatrics
Rothman

Jennifer Ann Rothman

Professor of Pediatrics

Sickle Cell Disease
Bone Marrow Failure Syndromes
General Hematology

Laura Martina De Castro

Adjunct Associate Professor in the Department of Medicine

Dr. De Castro is an assistant professor of medicine with the Division of Hematology in the Department of Medicine at Duke University. She is the clinical director of the adult comprehensive sickle cell clinic. Her translational research projects involve the evaluation of sickle red cell adhesion to laminin and its pathophysiological significance. In, addition, she has been the PI of more than 10 NIH or industry sponsored clinical studies on SCD and she is currently the Duke/UNC Sickle Cell Scholar, funded primarily through the Duke/UNC Sickle Cell Center.


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