A prospective, randomized study assessing different modalities for flushing totally implanted vascular access device...

Area of Science:

• Pediatric oncology
• Vascular access devices

Background:

• Totally implanted vascular access devices (TIVADs) are vital for chemotherapy and long-term infusions in pediatric patients.
• Maintaining TIVAD patency and longevity is essential for patient care.

Purpose of the Study:

• To evaluate the impact of different heparinized solutions on TIVAD patency in pediatric patients.
• To identify risk factors for TIVAD catheter occlusion.

Main Methods:

• Prospective study involving 81 pediatric patients receiving TIVADs.
• Randomized infusion of three different heparinized solutions (10 mL of 100 U/mL, 20 mL of 10 U/mL, 30 mL of 10 U/mL heparin).
• Analysis of catheter occlusion events, hospitalization, admissions, and puncture frequency.

Main Results:

• Catheter occlusion occurred in 46.9% of patients.
• High puncture frequency significantly increased the risk of TIVAD catheter occlusion.
• Heparin concentration (10 U/mL vs. 100 U/mL) and flush volume (10, 20, or 30 mL) did not affect occlusion risk.
• Urokinase successfully restored patency in occluded catheters.

Conclusions:

• Puncture frequency is the primary risk factor for TIVAD catheter occlusion in pediatric patients.
• Heparinized solutions at 10 U/mL are effective for TIVAD flushing, regardless of volume, similar to higher concentrations.