Effects of different rinsing regimen on totally implantable vascular access after 70 days infusion of total parenteral nutrition in vitro.

Totally implantable vascular access catheters with injection ports (IP) have been used for total parenteral nutrition (TPN). It is well known that thrombosis may cause occlusion of catheters. Recently we have experienced occlusion of the vascular access chambers in TPN-patients because of precipitation from the solutions. Three different IPs were tested in vitro: Port-A-Cath (PAC), Vascular-Access-Port (VAP), and Implantofix (IMP). Each received a daily infusion of a 2.5-liter solution consisting of fat emulsion, amino acids, glucose, and additives from a "3-liter bag." After infusions, the IPs were washed with three different rinsing methods, one including 45% v/v alcohol. After 70 days the ports were opened and examined for precipitation. Ports washed with alcohol showed no signs of precipitation, while four of six ports which were washed with conventional rinsing methods had precipitates.