Key result
Longer flushing intervals for implantable ports show no difference in late complications versus standard intervals.
Why the study?
The study was conducted to evaluate the safety and feasibility of flushing totally implantable vascular access devices (TIVADs) at intervals greater than 4 weeks.
Does a prolonged flushing interval (>4 weeks) increase port-related complications in patients with totally implantable vascular access devices compared to standard intervals?
Meta-Analysis
Does a prolonged flushing interval (>4 weeks) increase port-related complications in patients with totally implantable vascular access devices compared to standard intervals?
Prolonged flushing intervals (>4 weeks) for totally implantable vascular access devices appear safe and do not increase the risk of late complications compared to standard intervals.
Extended TIVAD flushing >4 weeks may be feasible; leaves open need for RCTs before practice change.
The objective of this systematic review is to evaluate the safety ad feasibility of the totally implantable vascular access devices (TIVADs) flushed more than 4 weeks. We searched the following electronic databases from the date their build-up to February 2020: PubMed, EMBASE, The Cochrane Central Register of Controlled Trials (CENTRAL), and CINAHL. The final selection resulted in 14 trials fulfilling the inclusion criteria and being included in our review. A pooled frequency of port-related late complications with longer flushing intervals (>4 weeks) was 8.0%, and the pooled frequency of occlusions, infections, and mechanical complications was 5.0%, 2.0%, and 3.0%, respectively. Then, we compared the frequency of port-related complications between standard and longer flushing intervals. There were no differences between the group's changes in the frequency of total late complications, occlusions, infections, and mechanical complications. This systematic review and meta-analysis demonstrates that longer flushing intervals for ports are safe. However, more prospective, power appropriated randomized trials are needed to explore the specific flushing time for ports.
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Xiong et al. (2021) conducted a meta-analysis in Totally implantable vascular access devices (TIVADs). Longer flushing intervals (>4 weeks) vs. Standard flushing intervals was evaluated on Port-related late complications. Longer flushing intervals (>4 weeks) for totally implantable vascular access devices had an 8.0% pooled frequency of late complications, with no difference compared to standard intervals.
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