Five Years of Experience in Patients Receiving Home Nutrition Support with the Implanted Reservoir: A Comparison with the External Catheter

This study examines 5 years (1983-1988) of home parenteral nutrition (HPN) experience in 27 patients using the implanted reservoir for venous access. Their catheter-related complications are compared to two control populations using the external catheter. Group I compares the 46 patients who all started HPN in the same 5-year period, group II compares 17 patients with experience of both types of venous access. For the entire 58 patients the average infusion time was 22 months (1 month-8.2 yr) and the average complication rate was about one complication every 2 years. Analyzing the separate groups however, group I implanted reservoir patients did better than those with the external catheter (p < 0.05) and group II external catheter patients did better than those with the implanted reservoir (p < 0.05). A possible explanation for this discrepancy is the greater medical competence of group I patients selecting the reservoir. The data show a clear separation of patients into those who have minimal complications with either device and others who have several complications with both. Two-thirds of the complications were infectious, one third mechanical. The infectious complications were similar with both catheters; clotting was more common with the external catheter and skin erosion was seen only with the reservoir. Eighty % of patients with experience with both type of venous access preferred the implanted reservoir. (Journal of Parenteral and Enteral Nutrition 13:478-483, 1989)