How to evaluate port function in a patient?

From the Guidelines

To evaluate port function in a patient, the first steps should include a chest radiograph and contrast study of the catheter. This approach is recommended for assessing a dysfunctional chest port and other central venous catheters (CVCs) 1. When evaluating port function, it's essential to consider the patient's overall clinical context, including any signs of infection, inflammation, or thrombotic complications.

Some key points to consider when assessing port function include:

• Visual inspection of the port site for signs of infection or inflammation
• Palpation of the port to ensure proper positioning
• Accessing the port using aseptic technique with a Huber needle
• Attempting to aspirate blood to confirm proper placement and patency
• Flushing the port with normal saline if blood return is good

However, a chest radiograph and contrast study of the catheter are the most appropriate initial steps for a comprehensive assessment 1. This approach can help identify any catheter-related complications, such as malposition, thrombosis, or fibrin sheath formation, which can impact port function.

In cases where thrombotic complications are suspected, catheter removal and placement of a new catheter from a different site, catheter exchange, contrast study of the catheter, and fibrin sheath stripping or disruption are excellent next steps 1. Additionally, preventive measures such as upper body insertion site and removal of the catheter in the setting of S aureus bacteremia can help reduce the risk of catheter-related bloodstream infections (CRBSI) 1.

Overall, proper port function assessment is crucial to prevent complications and ensure effective treatment. By following a systematic approach that includes imaging studies and clinical evaluation, healthcare providers can optimize port function and minimize the risk of adverse events.

From the Research

Evaluating Port Function

To assess port function in a patient, the following steps can be taken:

• Review the patient's medical history and current condition to determine the best approach for evaluation.
• Use non-invasive methods such as ultrasound elastography to measure liver and spleen stiffness, which can indicate the presence of portal hypertension and its severity 2.
• Check the port for any signs of complications, such as infection, thrombosis, or mechanical malfunction.
• Use imaging studies, such as CT scans, to visualize the port and surrounding tissues, if necessary.

Best Practices for Port Care

To ensure proper port function and prevent complications, the following best practices can be followed:

• Use non-coring needles and follow proper technique for accessing the port 3.
• Follow evidence-based guidelines for implanted port care to prevent central line-associated bloodstream infections (CLABSIs) 4.
• Monitor the patient for any signs of adverse events, such as those associated with contrast agents used in imaging studies 5, 6.

Additional Considerations

• The use of iodixanol as a contrast agent may be associated with a lower incidence of adverse events compared to other agents 6.
• The implementation of evidence-based standards and guidelines for CVAD practice can help prevent CLABSIs and ensure proper port function 4.