Port catheter

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The port catheter (port) is an implantable catheter system that is used in long-term therapy for infusions. It is often used for cancer. Read everything about the port catheter, how it works and what risks it entails.

What is a port catheter?

A port catheter consists of a chamber, which serves as a reservoir for the administered infusions, and a thin plastic tube connected to it. This is inserted into a large blood vessel and reaches just before the right atrium of the heart. The chamber is protected under the skin (subcutaneous) - in this way the risk of infection can be significantly reduced. It is closed by a silicone membrane. When doctors want to administer medication and other fluids, they pierce a special cannula (port needle with a thin tube to connect 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?

A port catheter is often used for cancer. It ensures long-term venous access through which infusions, for example in the case of chemotherapy, or large quantities of fluids - as in artificial nutrition, for example.

This saves the patient from frequent venipuncture and the associated risks. In addition, irritation of the vessel walls by chemotherapeutic agents can be avoided. These are conveyed directly to the heart through the port catheter and then quickly distributed and diluted with the bloodstream. Since the port catheter lies beneath the skin and is thus protected from external influences, it increases 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 do you place a port catheter?

Before the port catheter is implanted, the doctor will discuss the benefits and risks in person, check the blood values ​​and write an ECG. Under local anesthesia, the doctor then inserts a thin silicone tube (catheter), usually into the large arm or collarbone vein. He checks the catheter position with the help of an ultrasound. He then pushes the catheter into the superior vena cava until just before the right atrium of the heart.

A small skin incision below the collarbone creates a pocket 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 led 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 ensures the correct position and serves to rule out accidental injuries to the pleura or the lungs.

If an infusion is administered through the port catheter, the skin and hands are first carefully disinfected. A special port cannula is then pierced 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?

The risks of a port catheter are diverse, but can be minimized through professional intervention and consistent hygiene. Possible complications are:

• Infections
• Nerve injuries
• Bleeding and bruising (hematoma)
• Cardiac arrhythmias
• Pneumothorax - air enters the gap between the lungs and the pleura
• Injury to surrounding structures (organs, tissues)
• Air embolism - air enters blood vessels
• Blood clot (thrombus)
• pains
• Slipping of the port catheter
• Closure of the port catheter

Despite the location under the closed skin, infections (catheter infection) can only occur over 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 treatment of the infection (antibiotics, antimycotics) is therefore imperative. If in doubt, call an emergency doctor.

Fever with a suppressed immune system (immunosuppression) such as after chemotherapy is an emergency situation and must be treated quickly!

What do I have to consider with a port catheter?

Although the risk of infection with the port catheter is low, strict hygiene and careful care are mandatory. The puncture of the chamber may only be performed by trained nursing staff and doctors. Redness, swelling, and pain are signs of infection. If this is confirmed, the port catheter must be removed. Each patient receives a special port pass with information about the port catheter. These are particularly important when changing doctor or in an emergency situation.

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