Vascular Access - Port Systems
Vascular access is the most common invasive procedure performed in hospitals worldwide.1 Nearly all hospital inpatients receive access via the blood vessels during the course of their stay.
There are a variety of products available for these accesses, depending on the intended use and the patient's condition. For accesses that are placed on a long-term basis, port systems have now become established.
Design and function
A port is a permanent, implantable catheter system and consists of a port chamber, which is sealed with a thick silicone membrane (septum). The port body either consists of plastic, titanium or a combination of both materials, which is attached to a catheter by a radiopaque click connector. The catheter is either made of silicone or polyurethane (PUR).
Thanks to these special materials, the system can easily remain in the body for years before it should be exchanged or removed if necessary.2
During insertion procedure, the port system is placed in the vascular system, whereas the catheter is advanced (near) to the right atrium of the heart. The port system is usually implanted in the chest area – however, it is also possible to implant the port in different locations, such as in the arm. The insertion is performed completely subcutaneously so that the body can be easily palpated from the outside.
The port can be accessed by using a special needle (sometimes called a “Huber needle”). By accessing the port through the silicone membrane, the applied infusates enter the bloodstream directly via the catheter.
Indication and application fields
The port system can be used to apply the following solutions:
- drugs (e. g. cytostatics)
- infusion solutions (e. g. NaCl)
- blood products
- parenteral nutrition (supply of fluids and nutrients via the vascular system)
- contrast media for diagnostics (only used with port systems that are indicated as power injectable)3
Good to know
In case of poor vein conditions, implantable port systems can also be used for blood collection.
What are the advantages of a port system?
Particularly gentle & high comfort
- A port system is a central venous access device that is designed to allow infusates to be applied directly into the bloodstream without having to puncture a new vein for each treatment: thus, it simplifies the regular administration of medications and infusions such as chemotherapy, antibiotics or parenteral nutrition for patients, the attending physicians and nursing staff
- In exceptional cases, blood sampling is also feasible. Therefore, a port system is particularly vessel friendly
- The port system can remain in the body up until the end of the treatment
Suitable for everyday use
- Compared to other externally placed central venous access devices, an implantable port system allows to continue daily activities such as showering, swimming, tennis and jogging.
Cosmetically inconspicuous
- The port system is placed under the skin and is therefore usually cosmetically inconspicuous. Depending on the body constitution and thickness of skin, it will not be visible or only be noticeable on closer inspection.
Port system care
Ports that are not currently punctured also require regular care. In order to be able to guarantee the long-term, complication-free functionality of port systems even when not in use, regular port care in the form of flushing (e. g. with NaCl) should be performed carefully.
The catheter should be flushed at regular intervals according to the physicians judgement or the institution-specific guidelines in order to minimise the risk of e.g. infections or occlusions (blockage of the catheter).
In addition, the port should be locked when not in use2. For this purpose, the port system is filled with a locking solution that is to remain in the port catheter until the next application. This is for infection and thrombosis prevention.
For more detailed information on the care of ports, please refer to our nursing guide for port systems.
Downloads
References
- Helm RE, Klausner JD, Klemperer JD, Flint LM, Huang E. Accepted but unacceptable: peripheral IV catheter failure. J Infus Nurs. 2015 May-Jun;38(3):189-203. doi: 10.1097/NAN.0000000000000100. PMID: 25871866.
- Hennes, R.; Hofmann, H.: Ports: Versorgungsstandards – Implantationstechniken – Portpflege, 1. Aufl. 2016, Berlin Heidelberg, Deutschland: Springer, 2015
- Instructions for Use - Implantable vascular access port
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