{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T15:18:58Z","timestamp":1773242338805,"version":"3.50.1"},"reference-count":33,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2009,4,20]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> There are limited prospective data on whether the method of flushing affects the complication rate of tunnelled central venous catheters (CVCs). <\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p> During a 25-month period, 203 pediatric patients who had newly placed Broviac-Hickman CVCs were randomly assigned to standard flushing with heparin solution or to experimental flushing with normal saline via a positive-pressure cap. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Two hundred twenty-one complications were recorded among 75,249 CVC-days (2.94 per 1,000 CVC-days). A higher incidence of CVC occlusion (83 v 41 episodes; P = .0002) and bacteremia (24 v 9; P = .01) were found in the experimental arm. The cumulative probability of developing at least one CVC complication was higher in the experimental arm than in the standard arm (65.1% [95% CI, 55% to 75%] v 43.8% [95% CI, 34% to 54%], respectively; P = .01). No difference was found in either the cause or the frequency of premature removal of CVCs between the two study arms. After a median follow-up of 360 days (range, 4 to 1,073), CVC survival was similar: 77% (95% CI, 66% to 84%) for the experimental arm and 69% (95% CI, 53% to 80%) for the standard arm (P = .7). The factors associated with the occurrence of CVC complication were a diagnosis of leukemia\/lymphoma, double-lumen CVC, and experimental flushing. The only factor significantly associated with premature removal of a CVC was a diagnosis of leukemia\/lymphoma (hazard rate, 2.3; 95% CI, 1.1 to 4.7). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> An increased complication rate was found with normal saline flushing, but additional investigation is warranted to clarify whether it is related to saline use or to once-a-week flushing. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2008.19.4860","type":"journal-article","created":{"date-parts":[[2009,3,10]],"date-time":"2009-03-10T01:23:54Z","timestamp":1236648234000},"page":"2059-2065","source":"Crossref","is-referenced-by-count":55,"title":["Prospective, Randomized Trial of Two Different Modalities of Flushing Central Venous Catheters in Pediatric Patients With Cancer"],"prefix":"10.1200","volume":"27","author":[{"given":"Simone","family":"Cesaro","sequence":"first","affiliation":[{"name":"From Pediatric Hematology and Oncology; and Pediatric Surgery, Department of Pediatrics, University of Padova; and Microbiology and Virology; and Anesthesiology and Intensive Care Unit, Azienda Ospedaliera of Padova, Padova, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gloria","family":"Tridello","sequence":"additional","affiliation":[{"name":"From Pediatric Hematology and Oncology; and Pediatric Surgery, Department of Pediatrics, University of Padova; and Microbiology and Virology; and Anesthesiology and Intensive Care Unit, Azienda Ospedaliera of Padova, Padova, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mara","family":"Cavaliere","sequence":"additional","affiliation":[{"name":"From Pediatric Hematology and Oncology; and Pediatric Surgery, Department of Pediatrics, University of Padova; and Microbiology and Virology; and Anesthesiology and Intensive Care Unit, Azienda Ospedaliera of Padova, Padova, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Magagna","sequence":"additional","affiliation":[{"name":"From Pediatric Hematology and Oncology; 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