Catheter Survival During Long-Term Insulin Therapy With an Implanted Programmable Pump
- Marina Scavini, MD,
- Laura Galli, PHD,
- Sanford Reich, PHD,
- R Philip Eaton, MD,
- M Arthur Charles, MD,
- Fredrick L Dunn, MD and
- The Implantable Insulin Pump Trial Study Group
- Istituto Scientifico H San Raffaele Durham, North Carolina
- Milan, Italy; Strato/Infusaid, Durham, North Carolina
- Norwood, Massachusetts University of New Mexico Durham, North Carolina
- Albuquerque, New Mexico Diabetes Research Program Durham, North Carolina
- University of California Irvine, California and the Duke University Medical Center Durham, North Carolina
- Address correspondence and reprint requests to Marina Scavini, MD, Istituto Scientifico H San Raffaele, Via Olgettina 60, 20132 Milan, Italy. E-mail: scavinm{at}imihsra.hsr.it
Abstract
OBJECTIVE To survey catheter complications and to analyze catheter survival during long-term intraperitoneal and intravenous insulin therapy with an implanted programmable pump with a sideport.
RESEARCH DESIGN AND METHODS Catheter occlusions were documented by measuring dynamic catheter resistance. Catheter migrations or breaks were demonstrated by × ray. When flushing the catheter with buffer solution through the sideport failed to clear the occlusion, catheters were replaced or laparoscopy was performed for the excision of fibrous tissue growth. Broken or migrated catheters were replaced.
RESULTS Occlusions were the most common catheter complications, and the majority of them (79% intraperitoneal and 84% intravenous) were cleared by flushing the catheter. Survival at 3 years was significantly higher for intraperitoneal catheters compared with intravenous catheters (60% intraperitoneal and 22% intravenous).
CONCLUSIONS Nonsurgical management of catheter occlusions contributed to extend catheter lifetime. Intraperitoneal catheters have a lower morbidity and a higher survival than intravenous catheters.
- Received September 8, 1994.
- Accepted September 19, 1996.
- Copyright © 1997 by the American Diabetes Association
