![]() The 3 lumens of the catheter were flushed and closed with a solution of sterile, heparinized saline (100 IU heparin sulfate/mL, Pharmaceutical Partners of Canada, Richmond Hill, ON, Canada). The catheters were fixated to the patient by applying 2, nonabsorbable, Prolene skin sutures using the built-in catheter suturing wings (Ethicon US LLC, Somerville, NJ, USA). ![]() Using a 13F peel-away sheath (Cook Medial Inc., Bloomington, IN, USA), the catheter was manipulated to the superior vena cava–right atrial junction using fluoroscopy. The catheter was supplied with a standard 25-cm length, which was cut to a length that suited the patient’s anatomy. The HAS catheter was tunneled from an anterior chest wall location to the internal jugular vein access site. Right internal jugular venous access was achieved, with ultrasound and fluoroscopic guidance (see Fig. 3). As such, our local Research Ethics Committee waived the requirement for a full ethical review and approved this project.įluoroscopy imaging after catheter insertion. This was a retrospective review of the patient’s imaging and medical history for the purposes of a Quality Assurance project. We report our experience with this device in 19 patients. The Cook hyperalimentation (HAS) catheter was selected by the local Cancer Agency Stem-Cell Transplant team to be trialed as a triple-lumen catheter. Our local stem-cell transplant teams had been using a dual-lumen catheter and were in need of a triple-lumen catheter that would enhance patient management and facilitate medical and nursing care. The multiple lumens allow for the dedicated administration of medications, chemotherapy, fluids, blood products, and alimentation when clinically required. Multilumen venous access devices are extremely helpful for the management of patients undergoing stem-cell transplantation and have been shown to have manageable, if any, side effects. There was no obvious cause, or association, detected to explain the ballooning identified. After this pilot study of the HAS-catheter in these 19 patients, we discontinued use of this device at our facility due to mechanical problems of ballooned and obstructed middle lumens. We assessed, time in situ, follow-up imaging, chemotherapy regimen, possibility of systemic or device infection, tissue pathology of the patient's malignancy, and other factors to attempt to determine if there were any associations that could explain the catheter lumen failure. Three patient's experienced “ballooning” of the middle (white) lumen of the HAS catheter during routine use. Retrospectively, we reviewed each catheter. Nineteen HAS catheters were implanted in the right jugular vein, and tunneled to the right anterior chest wall, under imaging guidance. We relate our experience with the Cook (Cook Medial Inc., Bloomington, IN, USA), triple-lumen hyperalimentation (HAS) catheter for treatment related to autologous stem-cell transplant.
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