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How often should a port-A-cath be flushed?

Y S Kuo1, B Schwartz, J Santiago

  • 1Department of Obstetrics and Gynecology, New York Hospital Medical Center of Queens, Weill Cornell Medical College, Bronx, New York 10461, USA.

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|November 25, 2005
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Summary

Monthly port-a-cath (PAC) maintenance is excessive. Extending intervals between PAC accessions is medically safe, convenient, and efficient for patients and healthcare systems, reducing costs and patient burden.

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Area of Science:

  • Medical Devices
  • Oncology
  • Vascular Access

Background:

  • Regular heparin flushing of port-a-cath (PAC) is crucial during treatment.
  • Catheter maintenance requires evaluation for patients with retained ports post-therapy.

Purpose of the Study:

  • To demonstrate that longer intervals between PAC maintenance accessions are medically safe, convenient, and efficient.
  • To challenge the manufacturer's recommendation of monthly PAC maintenance.

Main Methods:

  • Retrospective review of 73 patients with PAC insertion (1988-2002).
  • Data collected: PAC insertion/accession dates, complications, flushing attempts.
  • Analysis included Mann-Whitney "U" test for interval accessions vs. complications.

Main Results:

  • Overall median accession interval was 42 days (mean 53.6 days).
  • Seven patients experienced difficulty drawing blood, with average intervals ranging from 38 to 244 days.
  • No statistically significant difference in complications between shorter and longer accession intervals (p>0.05).

Conclusions:

  • Monthly PAC maintenance is excessive, inconvenient, and costly.
  • Extended PAC maintenance intervals are medically safe and beneficial for patients, physicians, and healthcare systems.
  • Less frequent PAC accessions are safe and feasible, warranting further investigation.