Welcome to the Parent’s Education Center. We offer this as a resource to help you care for your child. However, nothing should replace the answers provided by your medical provider. We are not offering medical advice; please contact the care giver for your child.
What is a Central Venous Catheter?
In medicine, a central venous catheter (CVC) is used for the administration of chemotherapy, antibiotics, total parenteral nutrition (TPN), and blood sampling in patients with Cancer, Gastroenterology, Cardiology diseases or who require transplant. The tunneled catheter is implanted in the chest wall and the lines from the catheter site often times hang in the diaper area, or are within reach of tiny hands or mouths. The heavy lines pull on their tender skin on their chest.
What is a Port-a-Cath?
The term portacath is a portmanteau of “portal” and “catheter”. Port-a-Cath is a brand name; others include Microport, Bardport, PowerPort (power injectable), Passport, Infuse-a-Port, Medi-Port, and Lifesite (for hemodialysis patients). The term totally implantable venous access system (TIVAS) is also used. Additionally, portacaths are a form of a “central venous access device” and are frequently referred to as such in the medical field.
How does a Port work?
A port consists of a reservoir compartment (the portal) that has a silicone bubble for needle insertion (the septum), with an attached plastic tube (the catheter). The device is surgically inserted under the skin in the upper chest or in the arm and appears as a bump under the skin. It requires no special maintenance and is completely internal so swimming and bathing are not a problem. The catheter runs from the portal and is surgically inserted into a vein (usually the jugular vein, subclavian vein, or superior vena cava). Ideally, the catheter terminates in the superior vena cava, just upstream of the right atrium. This position allows infused agents to be spread throughout the body quickly and efficiently.
The septum is made of a special self-sealing silicone rubber; it can be punctured hundreds of times before it weakens significantly. To administer treatment or to withdraw blood, a health professional will first locate the port and disinfect the area. Then he or she will access the port by puncturing the overlying skin with a 90° Huber point needle although a Butterfly needle may also be used. (Due to its design, there is a very low infection risk, as the breach of skin integrity is never larger than the caliber of the needle. This gives it an advantage over indwelling lines such as the Hickman line.) Negative pressure is created to withdraw blood into the vacuumized needle, to check for blood return and see if the port is functioning normally. Next, the port will be flushed with a saline solution. Then, treatment will begin. After each use, a heparin lock is made by injecting a small amount of heparinized saline (an anticoagulant) into the device. This prevents development of clots within the port or catheter. In some catheter designs where there is a self-sealing valve at the far end, the system is locked with just saline. The port can be left accessed for as long as required. The port is covered in a dressing to protect the site from infection and to secure the needle in position.