Use of modified subcutaneous right-atrial catheter for venous access in leukaemic patients.

A large-diameter indwelling subcutaneous right-atrial catheter was inserted in 25 patients with haematological malignancies and neutropenia to provide ready access to the venous system for all infusions and blood aspirations. The median duration of catheter placement was 70 days. In 23 patients (92%) the catheter was used successfully until remission or death. Catheter-related exit-site infectons, generally mild, occurred in 14 patients (56%), Staphylococcus epidermidis being the predominant organism cultured. Septicaemia occurred in 11 neutropenic patients (44%). In 2 patients the same organism was grown from blood and exit site. The use of this catheter greatly facilitates patient care and support, minimises discomfort, and is associated with an acceptable rate of complications.