Author:

Keywords:

Totally Implanted Venous Access Devices, functional complications, maintenance protocols, Science & Technology, Life Sciences & Biomedicine, Oncology, Oncology & Carcinogenesis

Abstract:

Many oncology patients need a reliable venous access for the administration of chemotherapy: totally implanted venous access devices (TIVAD) allow infusion of drugs and blood sampling with a minimum of discomfort. For nurses, these devices are practical in use. However, device occlusion can occur leading to a delay in the prescribed therapy. Attempts to solve this problem is for both health care providers and patients a time-consuming task. Incidence rates of blood withdrawal occlusion (WO) varies from 3 to 28% of all accesses in different hospitals using different maintenance protocols. We hypothesized that differences in protocols of care can influence the incidence of withdrawal occlusion. Material and methods: In 2004, data on the incidence of WO in 8,658 TIVAD accesses were prospectively recorded in oncology day clinics in the frame of a multicentre study in Flanders conducted by VlaNinka (Flemish Network on Vascular Access). A secondary data-analysis was carried out trying to highlight risk factors related to the incidence of WO. Results: Relationship between flush solution (volume of normal saline, volume and concentration of heparin, syringe diameter), discard volume of first aspirate before blood sampling, number of days between needle change and incidence of WO will be reported. A flushing volume of 10 ml of normal saline is the optimal volume in reducing the risk on WO. Conclusion: Further research has to focus on all potential risk factors for development of WO such as insertion procedure, catheter tip position, device shape and material, compliance to maintenance protocols and differences in skills within nursing staff.