Background: Children and adolescents with
cancer often undergo aggressive treatment and receive supportive care requiring a long-term tunneled
central venous catheter (
TCVC). Regular
flushing promotes
TCVC patency when not in use (i.e., noninfusing). However,
TCVC flushing guidelines and the current practice of daily
flushing are not based on high-quality evidence. Few studies have compared the effect of less frequent
flushing on
TCVC patency. The purpose of this study was to evaluate the feasibility of a three times weekly
heparin flushing intervention, as compared to daily
heparin flushing, in children and adolescents and young adults (AYAs) with noninfusing TCVCs. Methods: Twenty children and AYAs were randomized to one of two groups, standard of care (SOC) (i.e., daily
heparin flushing) or intervention (three times weekly
heparin flushing) for 8 weeks. Feasibility data (recruitment, retention, acceptability,
TCVC patency, and complications) were analyzed descriptively. Results: Twenty of 22 eligible patients were enrolled in the study (90% recruitment rate). Four participants discontinued the study early due to
TCVC removal (20% attrition rate). One participant in each group had their
TCVC removed due to a central line-associated
bloodstream infection, one SOC group participant had their
TCVC removed due to damage, and one intervention group participant had their
TCVC removed due to discontinuation of treatment. No participants were withdrawn for safety concerns or because they did not find the protocol acceptable. Conclusions: It is feasible to conduct a large-scale randomized controlled trial to investigate a three times weekly
heparin flushing intervention in children and AYAs with TCVCs.