Port in oncology practice: 3-monthly locking with normal saline for catheter maintenance, a preliminary report

Solinas, Gianfranca; Platini, Francesca; Trivellato, Maurizio; Rigo, Carla; Alabiso, Oscar; Galetto, Alessandra

doi:10.5301/jva.5000740

Cited by 36 publications

(36 citation statements)

References 16 publications

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“…In 4 single‐arm studies (Bassi et al, ; Biffi et al, ; Diaz et al, ; Solinas et al, ), PACs were flushed every 6 or 12 weeks. A total of 925 patients were included, the frequencies of complications were 1.6%, 1.0% and 2.7% for infections, occlusions and mechanical complications respectively (Table ).…”

Section: Resultsmentioning

confidence: 99%

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Eight‐week interval in flushing and locking port‐a‐cath in cancer patients: A single‐institution experience and systematic review

et al. 2018

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Port‐a‐cath (PAC) system is one of the most frequently employed venous accesses for administration of chemotherapy and supportive care. To prevent late complications, the latest guidelines recommend flushing/locking procedures every four weeks. In this retrospective study, we evaluate the frequencies of late complications with a eight‐week flushing/locking procedure compared to the standard one. This study retrospectively compares the frequency of complications occurred using standard versus delayed flushing schedules. We performed a systematic review of the published studies about PAC complications associated with longer flushing intervals. Three hundred and ninety fully available patients were enrolled. One hundred and six patients had their PAC flushed/locked every month, 347 patients performed the flushing/locking procedures every eight weeks, 63 patients switched from the four to the eight‐week schedule. No difference was seen in the number of occlusions, infections and mechanical dysfunctions between the two patient groups. The systematic literature review confirmed, in a total of 1,347 patients, the absence of an increased proportion of complications with delayed schedules. PAC flushing and locking every eight weeks are feasible and safe. This delayed schedule may improve patients’ quality of life and decrease both nursing workload and costs for the national health system.

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Section: Resultsmentioning

confidence: 99%

“…However, this frequent timing is not very well accepted neither by the patients nor by the nursing staff. This is the reason why literature reports several attempts to delay the flushing and locking processes (Diaz et al, ; Solinas et al, ).…”

Section: Introductionmentioning

confidence: 99%

Eight‐week interval in flushing and locking port‐a‐cath in cancer patients: A single‐institution experience and systematic review

et al. 2018

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“…In the last decade, the attention of researchers has mainly been focused on identifying the best possible applicable solution for this procedure and on defining a correct execution technique. Several clinical studies published in the literature [2][3][4][5] and the latest international guidelines have established that, as far as non-dialysis catheters (NDCVA) are concerned, the standardized use of normal saline solution is to be preferred to anticoagulant solutions and, in particular, to heparinized saline solutions. In particular, the recent INS 2016 Standard of Practice and the Gruppo Accessi Venosi Centrali a Lungo Termine (GAVeCeLT) 2016 consensus of Italian experts have given clinical importance to this topic suggesting that normal saline solution is to be preferred in lieu of heparinized saline solution significant clinical relevance regarding the topic and suggest that normal saline solution is to be preferred in lieu of heparinized solutions, which, for the latest decades, have been considered a standard of practice.…”

mentioning

confidence: 99%

Extending the interval of flushing procedures of totally implantable vascular access devices in cancer patients: It is time for a change

Bertoglio

2020

J Vasc Access

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Several recent literature reports regarding the flushing technique of TIVADs highlight how the definition of the optimal flushing interval is still a source of controversy. Several recent studies indicate more and more frequently how 4 weeks can be considered a too short interval for the flushing of a totally implantable access device (TIVAD); on the other hand most of the main guidelines and instructions for use provided by the device’s manufacturers still suggest an interval between 4 weeks and 1 month as the ideal one. The recent meta-analysis by Wu et al. on this topic, promotes an important strategy change, indicating the possibility of extending the flushing intervals at least up to 8 weeks. This editorial extensively discusses the flushing methods of TIVADs highlighting the need for important and substantial changes, both in extending the range of flushes and in the solutions and methods to be used. It represents an invitation to the scientific community and device manufacturers for a complete revision of the indications on flushing techniques.

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“…Even if the standard schedule recommended by several guidelines is a 4-week locking with saline solution plus or minus heparin, delayed schedules (every 8 or 12 weeks) did not increase the risk of complications in 2 studies. 74,75 Based on these data, despite the absence of randomised trials, the delayed schedule of CVCs maintenance was recommended at our hospital.…”

Section: Maintenance Of Central Venous Cathetersmentioning

confidence: 99%

Systemic Treatment of Patients With Gastrointestinal Cancers During the COVID-19 Outbreak: COVID-19-adapted Recommendations of the National Cancer Institute of Milan

Pietrantonio

Morano

Niger

et al. 2020

Clinical Colorectal Cancer

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The current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak poses a major challenge in the treatment decision-making of patients with cancer, who may be at higher risk of developing a severe and deadly SARS-CoV-2 infection compared with the general population. The health care emergency is forcing the reshaping of the daily assessment between risks and benefits expected from the administration of immune-suppressive and potentially toxic treatments.To guide our clinical decisions at the National Cancer Institute of Milan (Lombardy region, the epicenter of the outbreak in Italy), we formulated Coronavirus-adapted institutional recommendations for the systemic treatment of patients with gastrointestinal cancers. Here, we describe how our daily clinical practice has changed due to the pandemic outbreak, with the aim of providing useful suggestions for physicians that are facing the same challenges worldwide.

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Port in oncology practice: 3-monthly locking with normal saline for catheter maintenance, a preliminary report

Abstract: Our data suggest that locking ports with normal saline every three months is not associated with an increased risk of lumen occlusion.

Cited by 36 publications

References 16 publications

Eight‐week interval in flushing and locking port‐a‐cath in cancer patients: A single‐institution experience and systematic review

Eight‐week interval in flushing and locking port‐a‐cath in cancer patients: A single‐institution experience and systematic review

Extending the interval of flushing procedures of totally implantable vascular access devices in cancer patients: It is time for a change

Systemic Treatment of Patients With Gastrointestinal Cancers During the COVID-19 Outbreak: COVID-19-adapted Recommendations of the National Cancer Institute of Milan

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