Safety of Extending Implanted Vascular Access Device Maintenance Flush Frequency

Background: Standards of care and guidelines acknowledge insufficient evidence that defines frequency of flushing for implanted vascular access devices (IVADs). Manufacturers recommend 4 weeks, but guidelines suggest that extending to 12 weeks is safe based on functionality.

Objectives: The study reviewed current standards of care for IVAD flush maintenance frequency, examined the characteristics of blood from IVADs by aspirating and observing contents prior to flushing when maintenance care is delayed beyond four weeks, and identified whether more research is required to determine optimal IVAD maintenance flush frequency.

Methods: An outpatient oncology clinic gathered data related to IVAD flush frequency during the COVID-19 pandemic. The concern was potentially harmful substances being flushed into the patient. A new method was developed to allow for observation of physiologic characteristics within the IVAD. Abnormal-appearing substances aspirated from the devices were discarded prior to use.

Findings: Visible clots and alterations in color and appearance were observed in 25% of the 59 patients observed between 8 and 17+ weeks when the IVAD reservoir was aspirated prior to flushing.