Heparinized Saline Flushed Catheter May Reduce Risk of Thrombosis in Cancer Patients Received Chemotherapy with Peripherally Inserted Central Catheter

Abstract

Objective: This study investigated the effect of heparinized saline flushed catheter on preventing catheter-related thrombosis (CRT) among cancer patients received peripherally inserted central catheter (PICC) for chemotherapy. Background: CRT is a common and serious complication when using PICC, which is one of the most commonly used vascular access devices for drug infusion, intravenous nutrition, and chemotherapy. Methods: This prospective, paralled-group trial enrolled 300 cancer patients received chemotherapy who were randomly assigned to the intervention (n=150) or control (n=150) group. Besides the basic procedure of PICC combined with IC- ECG and B-mode ultrasound imaging, heparinized saline flushed catheters were used in the intervention group, while normal saline flushed ones were used in the control group. Hemorheology tests and tip sites measurements were used in outcome evaluation, and the incidences of CRT and other complications. In additions, thromboelastogram (TEG) were used to measure thrombus elastic before and one week after PICC. Results: 148 patients in the intervention group and 138 patients in the control group finished PICC and follow-ups, which indicating longer duration and more completion of PICC with better catheter tip positioning in the intervention group. Intervention subjects showed significant lower incidences of CRT and other complications (phlebitis, catheter blockage, catheter prolapse, and local infection) (P <.05). In additons, our proposed method may reduce CRT incidence via significantly improving blood circulation among patients received chemotherapy via PICC. Conclusion: Heparinized saline flushed catheter may increase chemotherapy completion quality via PICC, reduce the risk of catheter-related thrombosis complications, and reduce CRT incidence via improving blood circulation. Conclusions: This proposed method can be easily introduced to prolong the duration of the placement and improve the blood circulation of cancer patients received PICC.