Prolonged flushing and locking interval for totally implantable vascular access device: A systematic review and meta-analysis.

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.

Prevalence of idle peripherally inserted central catheters in adult patients: A multicenter cross-sectional study.

BACKGROUND: Increasing studies concern about idle vascular access devices, but still scant data on idle peripherally inserted central catheters. We aimed to assess the prevalence and risks of idle peripherally inserted central catheters in adult patients. METHODS: A multicenter cross-sectional observational study was performed between April 2018 and July 2018. Patient demographics and peripherally inserted central catheters-related information were abstracted using a site questionnaire by directly inquiring and medical records reviewing right after their peripherally inserted central catheters were removed. RESULTS: Three hundred and fifty-eight patients with peripherally inserted central catheter episodes who met the inclusion criteria were studied. Of the 58,000 total catheter-days recorded, 5311 (9.2%) were considered as idle based on our study criteria. Two hundred and fifty-five (71.2%) patients had at least 1 idle catheter-day with a mean duration of 14.84 (19.31) idle days. The incidence of catheter-related complications in patients with idle peripherally inserted central catheters was lower than that in patients without idle peripherally inserted central catheters, though the difference did not reach statistical significance (odds ratio = 0.635, 95% confidence interval = 0.367-1.099, p = 0.103). CONCLUSION: In conclusion, idle peripherally inserted central catheters were common in adult patients, but the low risks of catheter-related complications may justify maintaining a peripherally inserted central catheter for further observation when necessary.