Extended Port Flush Maintenance Schedule Safe

Extending the interval of port flushes to every 12 weeks did not increase the incidence of port-related adverse events compared with the manufacturer-recommended interval, according to a recent study.

“Implanted ports are commonly used in the oncology setting as they provide long-term, easy central venous access for drug and treatment-related administrations,” explained study researcher Tali Lang, PhD, of Cabrini Research, Malvern, Victoria, Australia. “However, port usage may be associated with complications including infection, venous thrombosis, catheter occlusions, tip malposition, migration, and malfunction.”

Manufacturer guidelines recommend monthly maintenance port flushes to limit adverse events. However, there were no evidence-based data to support this recommendation.

In this study, Lang and colleagues enrolled oncology and hematology patients and compared the number of port removal and incidence of port-related complications between cohorts 1 and 2 (flushes every 4-8 weeks) and cohort 3 (flushes every 12 weeks). Data were extracted for 1,059 participants; 86% were female. Median age of participants was 66 years.

Overall, 37% of ports were removed. The percentages removed were comparable between the three cohorts: 25% in cohort 1, 30% in cohort 2 and 26% in cohort 3. Treatment cessation was the most documented reason for port removal.

There was no change in the incidence of port-related complications including suspected infection – the most common port-related complication leading to removal – and malfunction between the cohorts.

The researchers also collected feedback about maintenance port flush appointments and found that the majority of patients preferred a 12-week interval between flush appointments compared with 4 weeks.

“Extending the time frame between port flushes would be expected to be more cost effective by reducing staffing resources normally allocated to perform this procedure in the outpatient setting,” the researchers added. “In future studies, it would be important to undertake a cost benefit analysis of extending intervals.”

References

Is There a Relationship Between Frequency of Port-care Maintenance and Related Complications in Patients With Cancer?