From the Guidelines
Yes, IV fluids can be given through an implanted port, and ports are generally preferred for long-term IV access compared to PICC lines due to their lower infection rates and improved quality of life. According to the most recent and highest quality study 1, ports are appropriate for difficult venous access if use for 31 or more days is expected. The study also suggests that ports have lower infection rates and require less frequent maintenance compared to PICC lines.
Some key advantages of ports over PICC lines include:
- Lower infection rates
- Less frequent maintenance (flushing only needed every 4-6 weeks when not in use versus weekly for PICCs)
- Allow for normal activities including swimming
- Less visible as they're completely under the skin
- Can last for years, while PICC lines typically remain in place for weeks to months
However, ports require a surgical procedure for placement and removal, while PICC lines can be inserted and removed at bedside. Ports are also more expensive initially. The choice between a port and a PICC line depends on the expected duration of therapy, patient lifestyle considerations, and specific medical needs. For truly long-term IV access (months to years), ports generally provide better safety outcomes and quality of life, as supported by the study 1.
It's worth noting that the study 1 recommends the use of tunneled CVCs for long-term PN and home PN, but this does not directly compare ports and PICC lines. Another study 1 suggests that PICC-lines have limitations and cannot be recommended for HPN, which further supports the preference for ports over PICC lines for long-term IV access. Overall, the evidence suggests that ports are a better option for long-term IV access due to their lower infection rates and improved quality of life.
From the Research
IV Fluids Administration through a Port
- IV fluids can be given through a port, but the decision to use a port for this purpose should be made with caution, considering the potential risks and complications 2.
- The use of a port for IV fluids administration may be associated with a higher risk of complications, such as extravasation or infiltration, especially if the port is not properly managed 2.
Comparison with PICC Lines
- Central venous ports have been shown to have lower line infection rates compared to tunnelled catheters and PICC lines in patients undergoing infusional chemotherapy 3.
- However, the use of a port for IV fluids administration may not be safer than a PICC line in the long term, as it may require repeated percutaneous punctures and increase the risk of complications 2.
- PICC lines have been associated with a lower risk of complications, such as catheter-related bloodstream infections and thrombotic complications, in patients with hematologic malignancies 4.
Safety Considerations
- The safety of IV fluids administration through a port or a PICC line depends on various factors, including the patient's condition, the type of device used, and the quality of care provided 5.
- Proper maintenance and care of the device, including hand hygiene, dressing management, and access of intravenous infusion sets, are crucial to prevent complications and ensure safe administration of IV fluids 5.
- Nurses play a critical role in assessing patients' fluid status, administering and monitoring IV fluid therapy, and preventing complications associated with IV fluids administration 6.