2.50
Hdl Handle:
http://hdl.handle.net/10755/164884
Category:
Abstract
Type:
Presentation
Title:
HEPARIN FLUSHES IN CENTRAL VENOUS CATHETERS: ARE CANCER PATIENTS DIFFERENT?
Author(s):
Sylvanus, Terry; Harrison, Jean
Author Details:
Terry Sylvanus, MSN APRN BC AOCN, RN V, H Lee Moffitt Cancer Center, Tampa, Florida, USA, email: sylvantl@moffitt.org; Jean Harrison, MSN, RN, AOCN
Abstract:
The use of central venous catheters in cancer patients provides convenient access for multiple purposes, but is not without consequences or safety concerns in this population. Heparin flushes have been used to prevent loss of patency, but carry the risk of development of heparin-induced thrombocytopenia/thrombosis, prompting clinicians to speculate about the efficacy of normal saline flushes alone for this purpose. This review was designed to determine what evidence exists to support the use of dilute unfractionated heparin versus normal saline as a flush solution to maintain central venous catheter (CVC) patency in adult oncology patients. Two expert oncology nurses reviewed published guidelines, reviews and studies from 1979-2006 located through PubMed using evidence based practice filters, and through CINAHL using relevant search terms. Selection criteria for inclusion in the review was limited to randomized, prospective, controlled trials of the efficacy of any strength, volume and frequency of heparin flush compared to any volume and frequency of normal saline flush in the prevention of loss of patency or function, or thrombosis of a central venous catheter in adult patients with any cancer diagnosis. Pertinent studies were reviewed and summarized into an evidence table format. Guidelines available from national nursing organizations about central venous catheter care did not give specific information about flushing practices, nor use in oncology patients. The literature search yielded 468 studies, 102 examined some aspect of heparin or anticoagulant administration and CVC function; five met our rigorous selection criteria. No definitive answer to our clinical question was found. No studies reviewed provided sufficient evidence as to the superiority of normal saline versus heparin flushes for maintaining catheter patency in cancer patients. Our cancer centerÆs flushing protocols for CVCs are therefore unchanged. There remains an urgent need for well-designed, randomized, controlled, interdisciplinary research to address this issue in this population.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2007
Conference Name:
32nd Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Las Vegas, Nevada, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleHEPARIN FLUSHES IN CENTRAL VENOUS CATHETERS: ARE CANCER PATIENTS DIFFERENT?en_GB
dc.contributor.authorSylvanus, Terryen_US
dc.contributor.authorHarrison, Jeanen_US
dc.author.detailsTerry Sylvanus, MSN APRN BC AOCN, RN V, H Lee Moffitt Cancer Center, Tampa, Florida, USA, email: sylvantl@moffitt.org; Jean Harrison, MSN, RN, AOCNen_US
dc.identifier.urihttp://hdl.handle.net/10755/164884-
dc.description.abstractThe use of central venous catheters in cancer patients provides convenient access for multiple purposes, but is not without consequences or safety concerns in this population. Heparin flushes have been used to prevent loss of patency, but carry the risk of development of heparin-induced thrombocytopenia/thrombosis, prompting clinicians to speculate about the efficacy of normal saline flushes alone for this purpose. This review was designed to determine what evidence exists to support the use of dilute unfractionated heparin versus normal saline as a flush solution to maintain central venous catheter (CVC) patency in adult oncology patients. Two expert oncology nurses reviewed published guidelines, reviews and studies from 1979-2006 located through PubMed using evidence based practice filters, and through CINAHL using relevant search terms. Selection criteria for inclusion in the review was limited to randomized, prospective, controlled trials of the efficacy of any strength, volume and frequency of heparin flush compared to any volume and frequency of normal saline flush in the prevention of loss of patency or function, or thrombosis of a central venous catheter in adult patients with any cancer diagnosis. Pertinent studies were reviewed and summarized into an evidence table format. Guidelines available from national nursing organizations about central venous catheter care did not give specific information about flushing practices, nor use in oncology patients. The literature search yielded 468 studies, 102 examined some aspect of heparin or anticoagulant administration and CVC function; five met our rigorous selection criteria. No definitive answer to our clinical question was found. No studies reviewed provided sufficient evidence as to the superiority of normal saline versus heparin flushes for maintaining catheter patency in cancer patients. Our cancer centerÆs flushing protocols for CVCs are therefore unchanged. There remains an urgent need for well-designed, randomized, controlled, interdisciplinary research to address this issue in this population.en_GB
dc.date.available2011-10-27T12:08:42Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:08:42Z-
dc.conference.date2007en_US
dc.conference.name32nd Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationLas Vegas, Nevada, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.