Kudos to Raad et al for doing the study1 that begged to be done. I believe that Raad et al truly underestimated the insertion cost savings by not including the cost savings related to catheter removal. It is my estimation that catheter removal of the tunneled catheters could cost almost the same amount as that of insertion. That would change their cost savings from $2300 up to $4600 and make their annual cost savings in excess of $14 million. I would be interested in any data they have on that.
In the late 1980s, in Kansas City, Mo, we saw the utility of these nontunneled catheters. They were easier to place than centrally placed central venous catheters. We placed these catheters in several unique patients, such as one with secretory diarrhea (whose gastroenterologist wanted the bowel at rest). The second patient had congestive heart failure requiring inotropic support via