A Feasibility Study Of Obtaining Blood Specimens From Totally Implantable Venous Access Port

Background and objective:In the course of long-term and intermittent chemotherapy or biotherapy for cancer patients,frequent venous blood sampling is often needed to evaluate the changes of patients'condition and the response of the cancer treatment.At present,the standard venous blood sampling method is peripheral venous puncture.Frequent venipuncture brings great pain to these patients.As a safe,beautiftul and efficient vein pathway for cancer patients,TIVAPs are widely used.Cancer patients with TIVAPs often prefer blood draws from their TIVAP because peripheral sticks can be painful and may cause complications,such as hematoma.To date,there are few research on drawing blood specimens from TIVAPs.The techniques for blood draws from TIVAPs often are varies from region to region,patients may experience different techniques in different medical units.As a result,further research is needed to provide evidence-based support for changing clinical practice.The main purpose of this study is to determine if there is a difference in laboratory values between specimens collected from a TIVAP compared with venipuncture in oncology patients,and evaluate the feasibility of obtaining blood specimens from TIVAP in cancer patient.Method:The study was conducted using a within-subjects comparative design.Each patient had blood drawn using peripheral venous puncture technique(control group)and TIVAP technique(research group)at the same time.In order to evaluate whether the difference between the laboratory values of paired blood samples is clinically significant,deviation between the two groups were evaluated according to the documents of the Clinical Laboratory Improvement Amendment 88 and National Standard(GB/T 20470-2006).Results:A total of 41 patients with TIVAP were enrolled in this study.To test for overall mean differences between the 2 methods,paired t tests was performed for each of the 17 laboratory assays(chemistries and blood routine).There were only 4 assays that were statistically significant.And then,a series of Bland-Altman analyses was performed for both assays to investigate the consistency between the 2 methods.The 95%Confidence Interval of 95%LoA for each assay were found to be narrower than results that would be considered clinically acceptable;deviation between the laboratory values for each assay were clinically acceptable.That is to say,even those values that were statistically significant were not clinically significant.Conclusion:Blood samples obtained from totally implantable venous access port were effective,the values obtained by this methods are consistent and can be replaced by each other.