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Implanted ports

Our institution has noticed an increasing number of complications since we started using the implanted power ports. These complications have ranged from an increased number of them not infusing unless the patient is positioned just right (and some of these positions are not comfortable for any length of time), ruptures in the lumens, cracks in the port itself, etc. I would like to know if anyone else has experienced this?

Does all that repositoining

Does all that repositoining involve changing the position of the arm or shoulder? If so and the insertion site is the subclavian vein, more than likely this is pinch-off syndrome. This is directly related to the actual location of insertion being very medial and close to the junction of the clavicle and first rib. If nurses are forcefully injecting against the compression from these bones, damage to the catheter can result. Just a suggestion to check with the inserters. If these are jugular insertion, this would not be the problem though. Cracks in the port itself are difficult to cause. Are these plastic port bodies? I can not see how a metal port body would actually crack. Also it would take a huge amount of force to rupture a lumen of a port designed for high pressure. Have you contacted the port manufacturer? Have you returned an explanted problem port for their engineers to examine? Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Agree with Lynn....sounds

Agree with Lynn....sounds more like an inserter issue.  Teaching Hospital?? (July syndrome)  New medical staff?  Look at initial x-ray post placement and see if any issues were present at that time that use just made worse.



Something else that might be playing in is kinking of the catheter.  This can occur when the angle from the subq portion of the catheter into the venous entry portion is too acute as it turns.  This also is an inserter issue and might be why you are having to put the patient into certain positions--to try and straighten the cath out.  This is something different than the pinch off syndrome of the cath being compressed between the clavicle and first rib.  The kink, even a subtle one, can usually be seen on X-ray.  Sometimes, because the port is put in when patients are lying flat, when they sit up the position of the port moves and may affect the catheter.

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