Faculty Collaboration Database

Use of a dual lumen port for automated red cell exchange in adults with sickle cell disease. J Clin Apher 2015 Dec;30(6):353-8

Date

03/20/2015

Pubmed ID

25790325

DOI

10.1002/jca.21393

Scopus ID

2-s2.0-84955202216 (requires institutional sign-in at Scopus site)   27 Citations

Abstract

Red cell exchange (RCE) is a common procedure in adults with sickle cell disease (SCD). Implantable dual lumen Vortex (DLV) ports can be used for RCE in patients with poor peripheral venous access. We performed a retrospective cohort study of RCE procedures performed in adults with SCD. The main objective of the study was to compare the inlet speed, duration of procedures and rate of complications performed through DLV ports to those performed through temporary central venous and peripheral catheters. Twenty-nine adults with SCD underwent a total of 318 RCE procedures. Twenty adults had DLV ports placed and 218 procedures were performed using DLV ports. Mean length of follow-up after DLV port placement was 397 ± 263 days. Six DLV ports were removed due to infection and 1 for malfunction after a mean of 171 ± 120 days. Compared to temporary central venous and peripheral catheters, DLV port procedures had a greater rate of procedural complications, a longer duration, and a lower inlet speed (all P < 0.01). When accounting for the maximum allowable inlet speed to avoid citrate toxicity, 40% of DLV port procedures were greater than 10% below maximum speed, compared to 7 and 14% of procedures performed through temporary central venous and peripheral catheters (P < 0.0001). In conclusion, DLV ports can be used for RCE in adults with SCD, albeit with more procedural complications and longer duration. The smaller internal diameter and longer catheter of DLV ports compared to temporary central venous catheters likely accounts for the differences noted.

Author List

Shrestha A, Jawa Z, Koch KL, Rankin AB, Xiang Q, Padmanabhan A, Karafin MS, Field JJ

Authors

Joshua J. Field MD Professor in the Medicine department at Medical College of Wisconsin
Kathryn L. Koch NP APP Hybrid in the Medicine department at Medical College of Wisconsin
Amy R. Mager APP Hybrid in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Anemia, Sickle Cell
Blood Component Removal
Catheterization, Central Venous
Catheterization, Peripheral
Catheters, Indwelling
Cohort Studies
Erythrocyte Transfusion
Female
Humans
Male
Middle Aged
Retrospective Studies
Vascular Access Devices
Young Adult