Removal of totally implanted venous access ports for suspected infection in the intensive care unit: a multicenter observational study

• Main Authors: Marie Lecronier, Sandrine Valade, Naike Bigé, Nicolas de Prost, Damien Roux, David Lebeaux, Eric Maury, Elie Azoulay, Alexandre Demoule, Martin Dres, on behalf of the GrrrOH (Group for Research in Respiratory Intensive Care Onco-Hematology)
• Format: Article
• Language: English
• Published: SpringerOpen 2018-03-01
• Series: Annals of Intensive Care
• Subjects: Sepsis; Intensive care unit; Totally implantable venous access ports
• Online Access: http://link.springer.com/article/10.1186/s13613-018-0383-9

Abstract Background While no data support this practice, international guidelines recommend the removal of totally implanted venous access ports (TIVAPs) in patients with suspicion of TIVAP-related bloodstream infection admitted in the intensive care unit (ICU) for a life-threatening sepsis. Methods During this multicenter, retrospective and observational study, we included all patients admitted in five ICU for a life-threatening sepsis in whom a TIVAP was removed between January 2012 and December 2014. We aimed (1) at determining the proportion of confirmed TIVAP-related infections and (2) at assessing short- and long-term survival of patients with and without TIVAP-related infections. Results One hundred and fifty-one patients (58 ± 14 years, 62% males) were included between 2012 and 2014. TIVAP-related infections were confirmed in 68 patients (45%). Demographic characteristics were similar between patients with and without TIVAP-related infections. SOFA score on admission per point increase [odd ratio (OR), 0.86 interval confidence (IC) 95% (0.8–0.9), p < 0.01] and local signs of infection [OR 4.0, IC 95% (1.1–15.6), p = 0.04] were significantly associated with TIVAP-related infection. Patients with TIVAP-related infection had lower ICU and 6-month mortality as compared to their counterparts (9 vs. 40%, respectively, p < 0.01; and 50 vs. 66%, respectively, p = 0.04). TIVAP-related infection was significantly associated with ICU survival [OR 0.2, IC 95% (0.05–0.5), p < 0.01]. Conclusions TIVAP-related infection was confirmed in nearly one out of two cases of life-threatening sepsis in patients in whom it has been removed. TIVAP-related infection was associated with a good prognosis, as compared to patients with other causes of infection.