Impact of decreased heparin dose for flush‐lock of implanted venous access ports in pediatric oncology patients. Issue 5 (24th January 2014)

• Record Type: Journal Article
• Authors: Rosenbluth, Glenn; Tsang, Lisa; Vittinghoff, Eric; Wilson, Stephen; Wilson‐Ganz, Julie; Auerbach, Andrew
• Is Part Of: Pediatric blood & cancer. Volume 61:Issue 5(2014:May)
• Page Start: 855
• Page End: 858
• Publication Date: 2014-01-24
• Subjects: Tumors in children -- Periodicals; Blood -- Diseases -- Periodicals; Cancer in children -- Periodicals; 618.92
• DOI: 10.1002/pbc.24949
• Languages: English
• ISSNs: 1545-5009

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="pbc24949-sec-0001" sec-type="section"> <title>Background</title> <p>Faced with a lack of evidence, institutions often develop local protocols for use of heparin to flush‐lock venous access ports. Our objective was to evaluate catheter‐related complications in patients after introduction of a lower‐concentration heparin flush protocol.</p> </sec> <sec id="pbc24949-sec-0002" sec-type="section"> <title>Procedure</title> <p>Patients with implanted vascular access devices followed by a Pediatric Oncology service were exposed to a practice change in which heparin dose for flush‐lock was decreased from 5 ml of 100 units/ml to 5 ml of 10 units/ml. Outcome measures included port malfunctions leading to use of intra‐port tissue plasminogen activator (tPA), and positive blood cultures.</p> </sec> <sec id="pbc24949-sec-0003" sec-type="section"> <title>Results</title> <p>Rates of tPA usage were statistically similar before and after the practice change (0.82 compared to 0.59 per 100 line days absolute change −0.23, 95% CI −0.66, 0.20). Positive blood culture rates were also statistically similar before and after the practice change.</p> </sec> <sec id="pbc24949-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Children with implanted ports had similar complication rates and care safety measures whether their ports were flushed with 10 units/ml of heparin or 100 units/ml. Standardizing flush‐locks to lower doses of heparin may be a promising approach to maintaining port patency without compromising patient safety. Pediatr Blood Cancer 2014;61:855–858. © 2014 Wiley Periodicals, Inc.</p> </sec> </abstract>