What is a port catheter?
A port catheter consists of a chamber, which serves as a reservoir for the infusions administered, and a thin plastic tube connected to it. This is inserted into a large blood vessel and extends to just before the right atrium of the heart. The chamber lies protected under the skin (subcutaneous) – in this way the risk of infection can be significantly reduced. It is sealed by a silicone membrane. If doctors want to administer drugs and other fluids, they insert a special cannula (port needle, to which a thin tube is attached for connecting the infusions) through the skin and the silicone membrane. In principle, the port catheter can remain under the skin and in the vein for several years.
When do you place a port catheter?
This saves patients frequent venepunctures and the associated risks. In addition, irritation of the vessel walls by chemotherapeutic agents can be avoided. Through the port catheter, these are conducted directly to the heart and then rapidly distributed and diluted with the bloodstream. Since the port catheter lies beneath the skin and is thus protected from external influences, it enhances the quality of life. Swimming, bathing and sports are possible without any problems. Port catheters are implanted as early as possible, when the patient is still in good health.
How is a port catheter inserted?
Through a small skin incision below the collarbone, a pocket is formed in the subcutaneous tissue above the large pectoral muscle, into which the doctor inserts the chamber of the port catheter and fixes it to muscles or bones. The silicone tube is now passed through a tunnel under the skin to the chamber and connected to it. Then the skin is closed with sutures over the chamber. A final X-ray image ensures the correct position and serves to rule out accidental injury to the pleura or lungs.
If an infusion is administered via the port catheter, the skin and hands are first carefully disinfected. A special port cannula is then inserted through the skin into the chamber under the most sterile conditions possible so that infusions can be administered.
What are the risks of a port catheter?
- Infections
- Nerve injuries
- Bleeding and bruising (hematomas)
- Cardiac arrhythmias
- Pneumothorax – air gets into the gap between the lungs and the pleura
- Injury to surrounding structures (organs, tissues)
- Air embolism – air penetrates into vessels
- Blood clot (thrombus)
- Pain
- Slippage of the port catheter
- Occlusion of the port catheter
Despite the location under the closed skin, infections (catheter infection) can also occur only in the course of time. Patients with a port catheter usually receive chemotherapy, which can severely weaken the immune system. In this case, germs (often bacteria, but also fungi) can spread quickly and cause life-threatening blood poisoning (sepsis). Rapid therapy of the infection (antibiotics, antimycotics) is therefore imperative. In case of doubt, an emergency physician should be consulted.
What do I need to keep in mind with a port catheter?
Although the risk of infection with a port catheter is low, strict hygiene and careful care are mandatory. Puncture of the chamber should only be performed by trained nurses and physicians. Redness, swelling and pain are indications of infection. If this is confirmed, the port catheter must be removed. Each patient receives a special port passport with information about the port catheter. This is particularly important when changing doctors or in an emergency situation.
