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Pediatr Blood Cancer. 2014 May;61(5):855-8. doi: 10.1002/pbc.24949. Epub 2014 Jan 24.

Impact of decreased heparin dose for flush-lock of implanted venous access ports in pediatric oncology patients.

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1
Department of Pediatrics, UCSF Benioff Children's Hospital, San Francisco, California.

Abstract

BACKGROUND:

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.

PROCEDURE:

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.

RESULTS:

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.

CONCLUSIONS:

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.

KEYWORDS:

heparin; implanted ports; patient safety

PMID:
24464964
DOI:
10.1002/pbc.24949
[Indexed for MEDLINE]
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