Nursing interventions in prevention of the complication in locoregional administration of chemotherapy through port-a-cath system

Background: Port-a-cath is an implantable system, which can be inserted into the arterial or venous blood vessel. It enables more comfortable administration of drugs. Intraarterial chemotherapy has the greatest effect in the region downstream of the place of insertion, without major systemic side effects. The aim of the study was to evaluate complications during the administration of cytotoxic drugs through port-a-cath system. Patients and methods: Twenty colorectal cancer patients with liver metastases were entered into this investigation, and they were prospectively followed up. All of them had the intraarterial implantable device for intrahepatic drug delivery, and they were treated during six-month period. Nursing interventions serving to prevent complications of drug administration are as follows: preparing of the patient, check for the system, preparing cytotoxic drugs for the administration, control the patients and the drug flow during the administration of chemotherapy. Results: During this prospective follow up of our patients we noticed several problems related to the administration of chemotherapy through intraarterial port-a-cath systems. These difficulties include: difficulties in drug flow at the insertion point difficulties in blood aspiration (n=6), redness above the puncture, painful and moist skin lesions around the puncture (n=1). Conclusion: We did not notice frequent adverse effects of intrahepatic therapy because nursing interventions had been carefully planned in order to prevent the complications. Nurses should make an adequate health care plan based on the real and potential problems, with possible reasons and potential resolution of complications