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Prolonging the flush-lock interval of totally implantable venous access ports in patients with cancer: A systematic review and meta-analysis.
Wu, Xiaohong; Zhang, Tiantian; Chen, Lichan; Chen, Xisui.
  • Wu X; Shantou University Medical College, Shantou, China.
  • Zhang T; Shantou University Medical College, Shantou, China.
  • Chen L; Shantou University Medical College, Shantou, China.
  • Chen X; The First Affiliated Hospital of Shantou University Medical College, Shantou, China.
J Vasc Access ; 22(5): 814-821, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-740346
ABSTRACT

BACKGROUND:

Recently, some studies have shown that prolonging flush interval is safe and feasible for patients who complete chemotherapy. However, there is no consensus about the optimal flush interval for those patients.

OBJECTIVE:

The purpose of this review was to evaluate whether the flush interval could be prolonged based on monthly interval for regular maintenance and to explore the optimal flush interval. DATA SOURCES We searched the following databases for articles published between 1 January 1982 and 21 February 2020 PubMed, Cochrane Library, Web of Science, EMBASE, CINAHL, and Ovid. STUDY ELIGIBILITY CRITERIA Randomized controlled trials, retrospective and prospective cohort studies of flush interval less than 4 weeks versus longer than 4 weeks for patients who completed chemotherapy, were included.

RESULTS:

Two reviewers extracted information and assessed the quality of the articles independently. In total, 389 articles were retrieved, and 4 studies including 862 cases fulfilled the inclusion criteria. There was no statistical heterogeneity (I2 = 0, p > 0.05) among the included studies. Hence, the fixed-effects model was used for the meta-analysis. The meta-analysis showed that the total complication rate associated with longer than 4-week interval was higher than that associated with less than 4-week interval. Nevertheless, there was no significant difference between the two groups (7.2% vs 7.6%, p = 0.83). Moreover, the meta-analysis showed that the total complication and catheter occlusion rates associated with the 4-week interval were higher than those associated with the 8-week interval. However, there was no significant difference between the two groups (total complications 11.4% vs 9.5%, p = 0.68; catheter occlusions 4.9% vs 4.1%, p = 0.89).

LIMITATIONS:

Only four non-randomized controlled studies were included, and the outcomes of the included studies were reported incompletely.

CONCLUSION:

Extending the flush interval to longer than 4 weeks is safe and feasible. Based on previous studies, extending the flush interval to 8 weeks might not increase the incidence of total complications and catheter occlusions. However, there is no conclusion on whether the flush interval could be extended to 3 months or longer.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Catheterization, Central Venous / Neoplasms Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: J Vasc Access Journal subject: Vascular Diseases Year: 2021 Document Type: Article Affiliation country: 1129729820950998

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Catheterization, Central Venous / Neoplasms Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: J Vasc Access Journal subject: Vascular Diseases Year: 2021 Document Type: Article Affiliation country: 1129729820950998