Obtaining Coagulation Blood Samples From Central Venous Access Devices: A Review of the Literature

Background: Central venous access devices are used for chemotherapy and other medication administration, blood product administration, parenteral nutrition, and for obtaining blood samples in patients where the vasculature is difficult to access. Patients may need additional blood samples prior to invasive procedures and when clinical situations arise during cancer care. In addition, monitoring coagulability through ongoing blood testing is common in patients with cancer and requires repeated sampling to adjust anticoagulant medications. Objectives: The purpose of this review of the literature is to determine the best practices for collecting coagulation test samples from central venous access devices. Methods: The authors conducted a systematic review of the literature. Findings: The only method for obtaining reliable coagulation test results from central venous access devices is the flush then waste/discard method. This method has only been studied with peripherally inserted central catheters. Additional randomized, controlled trials with larger sample sizes are needed to determine the most appropriate method for drawing coagulation test results from central venous access devices.