NCPD Article

Central Line Patency: Management With Normal Saline Flushes for Adult Patients With Cancer

Grace Baek

Phuong Huynh

Terri Cunningham

Keith D. Eaton

Simran Ghuman

central venous catheter, flush, normal saline, heparin, alteplase, catheter occlusion
CJON 2023, 27(3), 274-280. DOI: 10.1188/23.CJON.274-280

Background: Central venous catheter (CVC) maintenance is critical in administering chemotherapy, transfusions, and high-frequency laboratory draws. Although normal saline (NS) flushes have been associated with similar incidences of irreversible port occlusions as heparin among adult patients with cancer and ports, additional research is needed regarding NS efficacy in other central line maintenance within large populations with cancer.

Objectives: The aim of this study was to analyze changes in reported CVC line patency via tissue plasminogen activator (tPA) administration rates in ports and other central lines because of an institutional switch from heparin to NS as preferred flushes in adult ambulatory patients with cancer.

Methods: Retrospective data were collected from patients with ports (3,706 prepolicy, 3,402 postpolicy) and nonport CVCs (816 prepolicy, 694 postpolicy).

Findings: Patients with nonport CVCs experienced similar tPA usage pre- versus postpolicy, versus an increased rate of tPA usage for ports. This policy resulted in institutional savings of $28,695.92. NS flushes are as effective as heparin for maintaining patency in ports and other CVCs for adult outpatients with cancer and address safety concerns with heparin-associated complications.

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