Rasero Laura, Golin Lisa, Ditta Serena, Di Massimo Dino Stefano, Dal Molin Alberto, Piemonte Guya
Associate Professor, Department of Health Science, University of Florence, Careggi Teaching Hospital, Florence, Italy.
Nurse, Oncology Outpatient Clinic, Careggi Teaching Hospital, Florence, Italy.
Br J Nurs. 2018 Apr 26;27(8):S4-S10. doi: 10.12968/bjon.2018.27.8.S4.
Totally implantable venous access device (TIVAD) lumen occlusion is a long-term complication of central venous catheters, associated with risks of infection, therapy interruptions and increased healthcare costs. The role of flushing and locking in maintaining TIVAD patency is paramount. Most flushing protocols are based on manufacturers' recommendations, which indicate that 4 weeks is the safest interval between two consecutive flushing procedures during periods when TIVADs are not in use. Conversely, results of several studies suggest that extended flushing intervals (FIs) do not increase the rate of obstructive or infective complications. The study aimed to describe the effects of prolonged FIs in a cohort of 317 patients with cancer. The authors found no significant difference in terms of TIVAD problems between long (>45 days) and short (≤45 days) FI groups, which raises questions over the validity of current practice.
完全植入式静脉通路装置(TIVAD)管腔闭塞是中心静脉导管的一种长期并发症,与感染风险、治疗中断及医疗费用增加相关。冲洗和封管在维持TIVAD通畅方面起着至关重要的作用。大多数冲洗方案基于制造商的建议,这些建议表明,在TIVAD未使用期间,连续两次冲洗程序之间4周是最安全的间隔时间。相反,几项研究的结果表明,延长冲洗间隔(FI)并不会增加阻塞性或感染性并发症的发生率。该研究旨在描述延长FI对317例癌症患者队列的影响。作者发现,长FI组(>45天)和短FI组(≤45天)在TIVAD问题方面没有显著差异,这对当前做法的有效性提出了质疑。