Safety and efficacy of the port-catheter systems during intensive intravenous chemotherapy in patients with multidrug-resistant tuberculosis and tuberculosis with extended resistance

Abstract

Background. Yu-Port (“Yuria-Pharm”) is an implanted system for long-term infusions. This system allows multiple access to vessels for parenteral administration of drugs, fluids and nutrient solutions. Objective. To describe the safety and efficacy of the port-catheter systems during intensive intravenous chemotherapy in patients with multidrug-resistant tuberculosis (TB) and TB with extended resistance. Materials and methods. Analysis of the literature on this issue. Results and discussion. Prolonged venous access is required in case of long-term infusion therapy or chemotherapy, as well as with the use of drugs that irritate the veins. Routine methods of vascular access have a number of disadvantages: the needle of the system damages the vessel with each injection; infusion cannula should be replaced every 3-5 days; the central venous catheter cannot be installed permanently (on average, for 1 week). Therefore, port systems consisting of a titanium port and a vascular catheter have long been used for long-term venous access. When installing the port system, the catheter is in the vein, the port is under the skin, and the needle is brought out. The advantages of the Yu-Port system include a large silicone membrane, fluid flow rate of 5 ml/s, compatibility with magnetic resonance imaging, and the absence of latex and polyvinyl chloride. The Yu-Port package contains installation instructions and all the necessary tools. The silicone membrane allows repeated piercing only with a special Yu-Port needle or the included needle. After the puncture, the membrane is tightened, because due to a special sharpening needle does not tear the membrane material, but pushes it apart. Jugular or subclavian access is most often used to install ports. The advantages of using port systems in chemotherapy include low traumaticity, painless injections, no discomfort, ease of drug administration and blood sampling for analysis, lower risk of developing phlebitis, long use duration (several years). Our own experience with port systems (56 patients in 2019-2020) showed significantly fewer premature treatment terminations due to side effects than in the group of standard infusion therapy (12.50 % vs. 22.6 %). Conclusions. 1. Port systems consisting of a titanium port and a vascular catheter have long been used for long-term venous access. 2. The advantages of using port systems in chemotherapy include painless injections, no discomfort, ease of drug administration and blood sampling for analysis, lower risk of phlebitis, long use duration. 3. In patients who need long-term or multicomponent chemotherapy, for example, in multidrug-resistant TB, it is advisable to use port systems.