Incidence and Determinants of Port Occlusions in Cancer Outpatients: A Prospective Cohort Study

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Abstract

BACKGROUND: Normal saline is considered a safe alternative for heparin as a locking solution in totally implantable venous access devices. The incidence rate of partial occlusion with the use of normal saline (easy injection, impossible aspiration) is estimated at 4%.

OBJECTIVE: The aim of this study was to investigate determinants of partial occlusions with the use of normal saline solution and the maintenance of positive pressure in the catheter.

METHODS: We enrolled 218 patients with different solid tumors who underwent pharmacologic treatment through the port with different frequencies: from once every week to at least once every month. The port was flushed with normal saline solution keeping a positive pressure in the catheter.

RESULTS: We performed 4111 observations and documented normal port functioning in 99% of observations (n = 4057) and partial occlusions in 1% of observations (n = 54). Partial occlusions were significantly associated with frequency of port flushing (P < .05), chemotherapy (P < .001), and blood sample collection (P < .001).

CONCLUSIONS: The use of positive pressure in addition to normal saline reduces the incidence rate of partial occlusions. The type of treatment, blood sample collection, and treatment schedule are important determinants of partial occlusions.

IMPLICATIONS FOR PRACTICE: Nurses play a key role in maintaining a functioning port using positive pressure during the flushing techniques. Certain risk factors must be monitored to prevent partial occlusions, and certain patients are more likely to present with port-related problems.

Original languageEnglish
Pages (from-to)102-107
Number of pages6
JournalCancer Nursing
Volume40
Issue number2
DOIs
Publication statusPublished - 2017

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Cohort Studies
Outpatients
Prospective Studies
Pressure
Incidence
Sodium Chloride
Neoplasms
Catheters
Heparin
Appointments and Schedules
Therapeutics
Nurses
Drug Therapy
Equipment and Supplies
Injections

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Ambulatory Care
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Neoplasms/drug therapy
  • Pressure
  • Prospective Studies
  • Risk Factors
  • Sodium Chloride/therapeutic use
  • Thrombosis/epidemiology
  • Vascular Access Devices

Cite this

@article{e4b1efc115fb4474a2c34997d3992176,
title = "Incidence and Determinants of Port Occlusions in Cancer Outpatients: A Prospective Cohort Study",
abstract = "BACKGROUND: Normal saline is considered a safe alternative for heparin as a locking solution in totally implantable venous access devices. The incidence rate of partial occlusion with the use of normal saline (easy injection, impossible aspiration) is estimated at 4{\%}.OBJECTIVE: The aim of this study was to investigate determinants of partial occlusions with the use of normal saline solution and the maintenance of positive pressure in the catheter.METHODS: We enrolled 218 patients with different solid tumors who underwent pharmacologic treatment through the port with different frequencies: from once every week to at least once every month. The port was flushed with normal saline solution keeping a positive pressure in the catheter.RESULTS: We performed 4111 observations and documented normal port functioning in 99{\%} of observations (n = 4057) and partial occlusions in 1{\%} of observations (n = 54). Partial occlusions were significantly associated with frequency of port flushing (P < .05), chemotherapy (P < .001), and blood sample collection (P < .001).CONCLUSIONS: The use of positive pressure in addition to normal saline reduces the incidence rate of partial occlusions. The type of treatment, blood sample collection, and treatment schedule are important determinants of partial occlusions.IMPLICATIONS FOR PRACTICE: Nurses play a key role in maintaining a functioning port using positive pressure during the flushing techniques. Certain risk factors must be monitored to prevent partial occlusions, and certain patients are more likely to present with port-related problems.",
keywords = "Adult, Aged, Aged, 80 and over, Ambulatory Care, Female, Humans, Incidence, Male, Middle Aged, Neoplasms/drug therapy, Pressure, Prospective Studies, Risk Factors, Sodium Chloride/therapeutic use, Thrombosis/epidemiology, Vascular Access Devices",
author = "Alessandra Milani and Ketti Mazzocco and Sara Gandini and Gabriella Pravettoni and Livio Libutti and Claudia Zencovich and Ada Sbriglia and Chiara Pari and Giorgio Magon and Luisa Saiani",
year = "2017",
doi = "10.1097/NCC.0000000000000357",
language = "English",
volume = "40",
pages = "102--107",
journal = "Cancer Nursing",
issn = "0162-220X",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Incidence and Determinants of Port Occlusions in Cancer Outpatients

T2 - A Prospective Cohort Study

AU - Milani, Alessandra

AU - Mazzocco, Ketti

AU - Gandini, Sara

AU - Pravettoni, Gabriella

AU - Libutti, Livio

AU - Zencovich, Claudia

AU - Sbriglia, Ada

AU - Pari, Chiara

AU - Magon, Giorgio

AU - Saiani, Luisa

PY - 2017

Y1 - 2017

N2 - BACKGROUND: Normal saline is considered a safe alternative for heparin as a locking solution in totally implantable venous access devices. The incidence rate of partial occlusion with the use of normal saline (easy injection, impossible aspiration) is estimated at 4%.OBJECTIVE: The aim of this study was to investigate determinants of partial occlusions with the use of normal saline solution and the maintenance of positive pressure in the catheter.METHODS: We enrolled 218 patients with different solid tumors who underwent pharmacologic treatment through the port with different frequencies: from once every week to at least once every month. The port was flushed with normal saline solution keeping a positive pressure in the catheter.RESULTS: We performed 4111 observations and documented normal port functioning in 99% of observations (n = 4057) and partial occlusions in 1% of observations (n = 54). Partial occlusions were significantly associated with frequency of port flushing (P < .05), chemotherapy (P < .001), and blood sample collection (P < .001).CONCLUSIONS: The use of positive pressure in addition to normal saline reduces the incidence rate of partial occlusions. The type of treatment, blood sample collection, and treatment schedule are important determinants of partial occlusions.IMPLICATIONS FOR PRACTICE: Nurses play a key role in maintaining a functioning port using positive pressure during the flushing techniques. Certain risk factors must be monitored to prevent partial occlusions, and certain patients are more likely to present with port-related problems.

AB - BACKGROUND: Normal saline is considered a safe alternative for heparin as a locking solution in totally implantable venous access devices. The incidence rate of partial occlusion with the use of normal saline (easy injection, impossible aspiration) is estimated at 4%.OBJECTIVE: The aim of this study was to investigate determinants of partial occlusions with the use of normal saline solution and the maintenance of positive pressure in the catheter.METHODS: We enrolled 218 patients with different solid tumors who underwent pharmacologic treatment through the port with different frequencies: from once every week to at least once every month. The port was flushed with normal saline solution keeping a positive pressure in the catheter.RESULTS: We performed 4111 observations and documented normal port functioning in 99% of observations (n = 4057) and partial occlusions in 1% of observations (n = 54). Partial occlusions were significantly associated with frequency of port flushing (P < .05), chemotherapy (P < .001), and blood sample collection (P < .001).CONCLUSIONS: The use of positive pressure in addition to normal saline reduces the incidence rate of partial occlusions. The type of treatment, blood sample collection, and treatment schedule are important determinants of partial occlusions.IMPLICATIONS FOR PRACTICE: Nurses play a key role in maintaining a functioning port using positive pressure during the flushing techniques. Certain risk factors must be monitored to prevent partial occlusions, and certain patients are more likely to present with port-related problems.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Ambulatory Care

KW - Female

KW - Humans

KW - Incidence

KW - Male

KW - Middle Aged

KW - Neoplasms/drug therapy

KW - Pressure

KW - Prospective Studies

KW - Risk Factors

KW - Sodium Chloride/therapeutic use

KW - Thrombosis/epidemiology

KW - Vascular Access Devices

U2 - 10.1097/NCC.0000000000000357

DO - 10.1097/NCC.0000000000000357

M3 - Article

C2 - 26925994

VL - 40

SP - 102

EP - 107

JO - Cancer Nursing

JF - Cancer Nursing

SN - 0162-220X

IS - 2

ER -