Skip to main content

2022 | OriginalPaper | Buchkapitel

13. Evidence of Port Care

verfasst von : Reinhart T. Grundmann

Erschienen in: Port Care

Verlag: Springer Berlin Heidelberg

Abstract

Evidence-based statements on port care are a rarity; most recommendations are based on empiricism. The most important measure in port care is compliance with hygiene guidelines. Only suitable special cannulas may be used for puncture. To reduce the risk of thrombosis and infection, blood sampling from the central venous line should be avoided. Ports should be flushed before and after fluid infusion or injection. There is no evidence for the type and amount of flushing solution, but usually only sterile saline is recommended for flushing and saline without added heparin may also be recommended for blocking the port.
Literatur
Zurück zum Zitat Bertoglio S, Solari N, Meszaros P, Vassallo F, Bonvento M, Pastorino S, Bruzzi P (2012) Efficacy of normal saline versus heparinized saline solution for locking catheters of totally implantable long-term central vascular access devices in adult cancer patients. Cancer Nurs 35:E35–E42CrossRef Bertoglio S, Solari N, Meszaros P, Vassallo F, Bonvento M, Pastorino S, Bruzzi P (2012) Efficacy of normal saline versus heparinized saline solution for locking catheters of totally implantable long-term central vascular access devices in adult cancer patients. Cancer Nurs 35:E35–E42CrossRef
Zurück zum Zitat Bischoff SC, Arends J, Dörje F et al (2013a) S3-Leitlinie der Deutschen Gesellschaft für Ernährungsmedizin (DGEM) in Zusammenarbeit mit der GESKES und der AKE. Künstliche Ernährung im ambulanten Bereich. Aktuel Ernahrungsmed 38:e101–e154CrossRef Bischoff SC, Arends J, Dörje F et al (2013a) S3-Leitlinie der Deutschen Gesellschaft für Ernährungsmedizin (DGEM) in Zusammenarbeit mit der GESKES und der AKE. Künstliche Ernährung im ambulanten Bereich. Aktuel Ernahrungsmed 38:e101–e154CrossRef
Zurück zum Zitat Bouza E, Burillo A, Muñoz P (2002) Catheter-related infections: diagnosis and intravascular treatment. Clin Microbiol Infect 8:265–274CrossRef Bouza E, Burillo A, Muñoz P (2002) Catheter-related infections: diagnosis and intravascular treatment. Clin Microbiol Infect 8:265–274CrossRef
Zurück zum Zitat Del Pozo JL, García Cenoz M, Hernáez S, Martínez A, Serrera A, Aguinaga A, Alonso M, Leiva J (2009) Effectiveness of teicoplanin versus vancomycin lock therapy in the treatment of port-related coagulase-negative staphylococci bacteraemia: a prospective case-series analysis. Int J Antimicrob Agents 34:482–485CrossRef Del Pozo JL, García Cenoz M, Hernáez S, Martínez A, Serrera A, Aguinaga A, Alonso M, Leiva J (2009) Effectiveness of teicoplanin versus vancomycin lock therapy in the treatment of port-related coagulase-negative staphylococci bacteraemia: a prospective case-series analysis. Int J Antimicrob Agents 34:482–485CrossRef
Zurück zum Zitat Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention beim Robert Koch-Institut (RKI) (2002) Prävention Gefäßkatheter-assoziierter Infektionen. Bundesgesundheitsbl—Gesundheitsforsch -Gesundheitsschutz 45:907–924 Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention beim Robert Koch-Institut (RKI) (2002) Prävention Gefäßkatheter-assoziierter Infektionen. Bundesgesundheitsbl—Gesundheitsforsch -Gesundheitsschutz 45:907–924
Zurück zum Zitat Goossens GA (2015) Flushing and locking of venous catheters: available evidence and evidence deficit. Nurs Res Pract 2015:985686PubMedPubMedCentral Goossens GA (2015) Flushing and locking of venous catheters: available evidence and evidence deficit. Nurs Res Pract 2015:985686PubMedPubMedCentral
Zurück zum Zitat Goossens GA, Jérôme M, Janssens C, Peetermans WE, Fieuws S, Moons P, Verschakelen J, Peerlinck K, Jacquemin M, Stas M (2013) Comparing normal saline versus diluted heparin to lock non-valved totally implantable venous access devices in cancer patients: a randomised, non-inferiority, open trial. Ann Oncol 24:1892–1899CrossRef Goossens GA, Jérôme M, Janssens C, Peetermans WE, Fieuws S, Moons P, Verschakelen J, Peerlinck K, Jacquemin M, Stas M (2013) Comparing normal saline versus diluted heparin to lock non-valved totally implantable venous access devices in cancer patients: a randomised, non-inferiority, open trial. Ann Oncol 24:1892–1899CrossRef
Zurück zum Zitat Kao HF, Chen IC, Hsu C, Chang SY, Chien SF, Chen YC, Hu FC, Yang JC, Cheng AL, Yeh KH (2014) Chlorhexidine for the prevention of bloodstream infection associated with totally implantable venous ports in patients with solid cancers. Support Care Cancer 22:1189–1197CrossRef Kao HF, Chen IC, Hsu C, Chang SY, Chien SF, Chen YC, Hu FC, Yang JC, Cheng AL, Yeh KH (2014) Chlorhexidine for the prevention of bloodstream infection associated with totally implantable venous ports in patients with solid cancers. Support Care Cancer 22:1189–1197CrossRef
Zurück zum Zitat Kefeli U, Dane F, Yumuk PF, Karamanoglu A, Iyikesici S, Basaran G, Turhal NS (2009) Prolonged interval in prophylactic heparin flushing for maintenance of subcutaneous implanted port care in patients with cancer. Eur J Cancer Care (Engl) 18:191–194CrossRef Kefeli U, Dane F, Yumuk PF, Karamanoglu A, Iyikesici S, Basaran G, Turhal NS (2009) Prolonged interval in prophylactic heparin flushing for maintenance of subcutaneous implanted port care in patients with cancer. Eur J Cancer Care (Engl) 18:191–194CrossRef
Zurück zum Zitat Kuo YS, Schwartz B, Santiago J, Anderson PS, Fields AL, Goldberg GL (2005) How often should a port-a-Cath be flushed? Cancer Investig 23:582–585CrossRef Kuo YS, Schwartz B, Santiago J, Anderson PS, Fields AL, Goldberg GL (2005) How often should a port-a-Cath be flushed? Cancer Investig 23:582–585CrossRef
Zurück zum Zitat Kurul S, Saip P, Aydin T (2002) Totally implantable venous-access ports: local problems and extravasation injury. Lancet Oncol 3:684–692CrossRef Kurul S, Saip P, Aydin T (2002) Totally implantable venous-access ports: local problems and extravasation injury. Lancet Oncol 3:684–692CrossRef
Zurück zum Zitat Liu Y, Zhang AQ, Cao L, Xia HT, Ma JJ (2013) Taurolidine lock solutions for the prevention of catheter-related bloodstream infections: a systematic review and meta-analysis of randomized controlled trials. PLoS One 8:e79417CrossRef Liu Y, Zhang AQ, Cao L, Xia HT, Ma JJ (2013) Taurolidine lock solutions for the prevention of catheter-related bloodstream infections: a systematic review and meta-analysis of randomized controlled trials. PLoS One 8:e79417CrossRef
Zurück zum Zitat Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O’Grady NP, Raad II, Rijnders BJ, Sherertz RJ, Warren DK (2009) Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis 49:1–45CrossRef Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O’Grady NP, Raad II, Rijnders BJ, Sherertz RJ, Warren DK (2009) Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis 49:1–45CrossRef
Zurück zum Zitat Odabas H, Ozdemir NY, Ziraman I, Aksoy S, Abali H, Oksuzoglu B, Isik M, Civelek B, Dede D, Zengin N (2014) Effect of port-care frequency on venous port catheter-related complications in cancer patients. Int J Clin Oncol 19:761–766CrossRef Odabas H, Ozdemir NY, Ziraman I, Aksoy S, Abali H, Oksuzoglu B, Isik M, Civelek B, Dede D, Zengin N (2014) Effect of port-care frequency on venous port catheter-related complications in cancer patients. Int J Clin Oncol 19:761–766CrossRef
Zurück zum Zitat Pittiruti M, Bertoglio S, Scoppettuolo G et al (2016) Evidence-based criteria for the choice and the clinical use of the most appropriate lock solutions for central venous catheters (excluding dialysis catheters): a GAVeCeLT consensus. J Vasc Access 17:453–464CrossRef Pittiruti M, Bertoglio S, Scoppettuolo G et al (2016) Evidence-based criteria for the choice and the clinical use of the most appropriate lock solutions for central venous catheters (excluding dialysis catheters): a GAVeCeLT consensus. J Vasc Access 17:453–464CrossRef
Zurück zum Zitat Rosenbluth G, Tsang L, Vittinghoff E, Wilson S, Wilson-Ganz J, Auerbach A (2014) Impact of decreased heparin dose for flush-lock of implanted venous access ports in pediatric oncology patients. Pediatr Blood Cancer 61:855–858CrossRef Rosenbluth G, Tsang L, Vittinghoff E, Wilson S, Wilson-Ganz J, Auerbach A (2014) Impact of decreased heparin dose for flush-lock of implanted venous access ports in pediatric oncology patients. Pediatr Blood Cancer 61:855–858CrossRef
Zurück zum Zitat Vassallo M, Dunais B, Roger PM (2015) Antimicrobial lock therapy in central-line associated bloodstream infections: a systematic review. Infection 43:389–398CrossRef Vassallo M, Dunais B, Roger PM (2015) Antimicrobial lock therapy in central-line associated bloodstream infections: a systematic review. Infection 43:389–398CrossRef
Zurück zum Zitat Vescia S, Baumgärtner AK, Jacobs VR, Kiechle-Bahat M, Rody A, Loibl S, Harbeck N (2008) Management of venous port systems in oncology: a review of current evidence. Ann Oncol 19:9–15CrossRef Vescia S, Baumgärtner AK, Jacobs VR, Kiechle-Bahat M, Rody A, Loibl S, Harbeck N (2008) Management of venous port systems in oncology: a review of current evidence. Ann Oncol 19:9–15CrossRef
Metadaten
Titel
Evidence of Port Care
verfasst von
Reinhart T. Grundmann
Copyright-Jahr
2022
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-662-64494-2_13