TỔNG QUAN VỀ CHĂM SÓC VÀ QUẢN LÝ BUỒNG TIÊM TRUYỀN DƯỚI DA

Abstract

Background: Totally implantable venous access devices (TIVADs) provide durable central venous access, but safe use depends on standardized approaches to access, maintenance, complication surveillance, and nursing competency; Vietnamese evidence remains scattered and has not been systematically synthesized.

Objectives: To (1) describe standard practice for TIVAD care and maintenance and benchmark it against practice in Vietnam; (2) analyze the burden of complications and the measures used to prevent, detect, and manage them; and (3) clarify the nursing role and the current state of nursing knowledge, practice, and patient education.

Methods: This thematic narrative review, reported in accordance with the SANRA guidelines, searched PubMed, Cochrane Library, CINAHL, and Google Scholar (through 31 March 2026), together with Vietnamese nursing sources (Vietnam Medical Journal, Vietnam Journal of Nursing, and the Ministry of Health portal). Selection was purposive rather than systematic, and, owing to the journal’s length limit, only thirteen core sources were cited directly.

Results: (1) Core practices include aseptic non-touch technique, alcohol-based chlorhexidine antisepsis, dedicated non-coring port needles, blood-return assessment before infusion, and intermittent pulsatile 0.9% saline flushing ending with positive pressure; the lock solution and maintenance interval should be individualized, with an interval of 8–12 weeks potentially appropriate for selected, stable patients under surveillance; Vietnam currently has no unified national guideline. (2) Principal complications comprise infection, occlusion, thrombosis, extravasation, and mechanical failure; a 2025 retrospective study of 109 patients in Hanoi reported an overall complication rate of 6.4% (local infection 1.8%, bloodstream infection 0.9%, thrombosis 0.9%) and two device removals; prevention rests on aseptic non-touch technique, correct flushing technique, and scheduled clinical assessment, whereas management differs markedly by complication type. (3) Nursing knowledge and practice are uneven: a 2026 survey of 120 nurses in Da Nang found that 68.3% had moderate-to-poor knowledge and only 5.8% correctly identified the maximum needle dwell time; formal training was significantly associated with knowledge scores, and structured educational intervention markedly improved knowledge and skills.

Conclusions: Safe TIVAD care requires evidence-based protocols, competency validation aligned with the nursing care cycle, patient education, and complication surveillance. Vietnam needs harmonized national guidance, quality indicators, and multicenter research to validate context-appropriate maintenance strategies.