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Saline solution flush cvc

Anne-Marie Chaftari, Ray Hachem, Ariel Szvalb, Mahnaz Taremi, Bruno Granwehr, George Michael Viola, Amin Sapna, Andrew Assaf, Yazan Numan, Pankil Shah, Ketevan Gasitashvili, Elizabeth Natividad, Ying Jiang, Rebecca Slack, Ruth Reitzel, Joel Rosenblatt, Elie Mouhayar, Issam Raad
For long-term central lines (CL), the lumen is the major source of central line-associated bloodstream infections (CLABSI). The current standard of care for maintaining catheter patency includes flushing the CL with saline or heparin. Neither agent has any antimicrobial activity. Furthermore, heparin may enhance staphylococcal biofilm formation. We evaluated the safety and efficacy of a novel nonantibiotic catheter lock solution for the prevention of CLABSI. Between November 2015 and February 2016, we enrolled 60 patients with hematologic malignancies who had peripherally inserted central catheters (PICC) to receive the study lock solution...
July 2017: Antimicrobial Agents and Chemotherapy
Claudia Lucarelli, Enea Gino Di Domenico, Luigi Toma, Domenico Bracco, Grazia Prignano, Maria Fortunati, Lorella Pelagalli, Fabrizio Ensoli, Patrizio Pezzotti, Aurora García-Fernández, Annalisa Pantosti, Loredana Ingrosso
BACKGROUND: Ralstonia spp, an environmental microorganism, has been occasionally associated with healthcare infections. The aim of this study was to investigate an outbreak caused by Ralstonia mannitolilytica in oncology patients. METHODS: Case definition: Oncology outpatients attending a day ward, with positive blood and/or central venous catheter (CVC) culture for Ralstonia spp from September 2013 - June 2014. We analysed medical records, procedures and environmental samples...
2017: Antimicrobial Resistance and Infection Control
Lei Zhong, Hai-Li Wang, Bo Xu, Yao Yuan, Xin Wang, Ying-Ying Zhang, Li Ji, Zi-Mu Pan, Zhan-Sheng Hu
BACKGROUND: Heparin saline (HS) is theoretically superior to normal saline (NS) for maintaining the patency of central venous catheters (CVCs), but the comparative efficacy of them remains controversial. The aim of this systematic review and meta-analysis was to assess the efficacy of NS versus HS in the maintenance of the patency of CVCs in adult patients. METHODS: We searched PubMed, Embase and the Cochrane library databases. Randomized controlled trials (RCTs) evaluating the use of NS vs...
January 8, 2017: Critical Care: the Official Journal of the Critical Care Forum
Mauro Pittiruti, Sergio Bertoglio, Giancarlo Scoppettuolo, Roberto Biffi, Massimo Lamperti, Alberto Dal Molin, Nicola Panocchia, Nicola Petrosillo, Mario Venditti, Carla Rigo, Enrico DeLutio
BACKGROUND: The most appropriate lock solution for central venous access devices is still to be defined. GAVeCeLT - the Italian group for venous access devices - has developed a consensus on the evidence-based criteria for the choice and the clinical use of the most appropriate lock solution for central venous catheters (excluding dialysis catheters). METHOD: After the constitution of a panel of experts, a systematic collection and review of the literature has been performed, focusing on clinical studies dealing with lock solutions used for prevention of occlusion (heparin, citrate, urokinase, recombinant tissue plasminogen activator [r-TPA], normal saline) or for prevention of infection (citrate, ethanol, taurolidine, ethylene-diamine-tetra-acetic acid [EDTA], vancomycin, linezolid and other antibiotics), in both adults and in pediatric patients...
November 2, 2016: Journal of Vascular Access
Eduardo José Ferreira Dos Santos, Maria Madalena Jesus Cunha Nunes, Daniela Filipa Batista Cardoso, João Luís Alves Apóstolo, Paulo Joaquim Pina Queirós, Manuel Alves Rodrigues
OBJECTIVE: Determining which is the most effective solution (heparin flush compared to 0.9% saline flush) for reducing the risk of occlusions in central venous catheters (CVC) in adults. METHOD: The systematic review followed the principles proposed by the Cochrane Handbook; critical analysis, extraction and synthesis of data were performed by two independent researchers; statistical analysis was performed using the RevMan program 5.2.8. RESULTS: Eight randomized controlled trials and one cohort study were included and the results of the meta-analysis showed no difference (RR=0...
December 2015: Revista da Escola de Enfermagem da U S P
Mohsen Ziyaeifard, Azin Alizadehasl, Nahid Aghdaii, Ali Sadeghi, Rasoul Azarfarin, Gholamreza Masoumi, Ghodrat Golbargian
BACKGROUND: Heparinized saline solution is used to prevent occlusion in the arterial catheters and central venous pressure monitoring catheters. Even at low dose, heparin administration can be associated with serious complications. Normal saline solution can maintain patency of arterial catheters and central venous pressure monitoring catheters. OBJECTIVES: The current study aimed to compare the efficacy of normal saline with that of heparinized one to maintain patency of arterial and central venous catheters after cardiac surgery...
August 2015: Anesthesiology and Pain Medicine
Giovanna Figueiredo, Teresa Fiebig, Stefanie Kirschner, Omid Nikoubashman, Lisa Kabelitz, Ahmed Othman, Andrea Nonn, Martin Kramer, Marc A Brockmann
BACKGROUND: Repetitive administration of medication or contrast agents is frequently performed in mice. The introduction of vascular access mini-ports (VAMP) for mice allows long-term vascular catheterization, hereby eliminating the need for repeated vessel puncture. With catheter occlusion being the most commonly reported complication of chronic jugular vein catheterization, we tested whether digital subtraction angiography (DSA) can be utilized to evaluate VAMP patency in mice. METHODS: Twenty-three mice underwent catheterization of the jugular vein and subcutaneous implantation of a VAMP...
2015: PloS One
Mohammad Ali Heidari Gorji, Fatemeh Rezaei, Hedayat Jafari, Jamshid Yazdani Cherati
BACKGROUND: Occlusion of central venous catheters is one of the limiting factors in using them. Heparinized saline solution is the standard solution used for keeping the catheters open. OBJECTIVES: This study aimed to determine the effect of heparin saline solution and normal saline in maintenance of patency of central venous catheters. PATIENTS AND METHODS: This double-blind study was performed on 84 patients of intensive care unit who had central venous catheters...
April 2015: Anesthesiology and Pain Medicine
Eduardo López-Briz, Vicente Ruiz Garcia, Juan B Cabello, Sylvia Bort-Marti, Rafael Carbonell Sanchis, Amanda Burls
BACKGROUND: Heparin intermittent flushing is a standard practice in the maintenance of patency in central venous catheters. However, we could find no systematic review examining its effectiveness and safety. OBJECTIVES: To assess the effectiveness of intermittent flushing with heparin versus 0.9% sodium chloride (normal saline) solution in adults with central venous catheters in terms of prevention of occlusion and overall benefits versus harms. SEARCH METHODS: The Cochrane Peripheral Vascular Diseases Group Trials Search Co-ordinator searched the Specialised Register (last searched December 2013) and the Cochrane Central Register of Controlled Trials (CENTRAL) (2013, Issue 11)...
October 8, 2014: Cochrane Database of Systematic Reviews
Megan K Luther, Leonard A Mermel, Kerry L LaPlante
OBJECTIVES: Antimicrobial lock solutions are used for prevention and management of catheter-related bloodstream infections. ML8-X10 (a prototype oil-in-water micro-emulsion based on a novel free fatty acid), vancomycin/heparin and taurolidine/citrate/heparin (Taurolock™-Hep500) lock solutions were tested against biofilm-forming Staphylococcus epidermidis and methicillin-susceptible Staphylococcus aureus. METHODS: MICs were tested in neutral broth (pH ~7) and acidified broth (pH 5)...
December 2014: Journal of Antimicrobial Chemotherapy
Alberto Dal Molin, Elias Allara, Doriana Montani, Simona Milani, Cristina Frassati, Simonetta Cossu, Simone Tonella, Dania Brioschi, Laura Rasero
PURPOSE: The aim of this systematic review was to assess the efficacy of heparin flushing in the lock of central venous catheters. METHODS: We searched MEDLINE and CINAHL databases. Eligible studies were randomized controlled trials evaluating the use of heparin versus normal saline or other solution in the flushing of central catheter among adult patients. No language restrictions were applied. Two reviewers independently screened titles and abstracts in order to identify relevant publications...
July 2014: Journal of Vascular Access
B Linnemann, E Lindhoff-Last
Central venous catheters (CVCs) are important tools in the care of patients with acute or chronic diseases, but catheter-related thrombosis and thrombotic occlusions are frequent complications, especially if CVCs are implanted for long-term use. In this review we focus on the management of these complications. Risk factors for catheter-related thrombosis include dislocation of the catheter tip, the presence of malignant disease and hypercoagulability. Catheter-related thrombosis is associated with catheter infection, pulmonary embolism and post-thrombotic syndrome...
December 2013: Zentralblatt Für Chirurgie
C Puiggròs, C Cuerda, N Virgili, M L Chicharro, C Martínez, C Garde, D de Luis
UNLABELLED: In adult home parenteral nutrition (HPN) programme patients up to now no evidence-based recommendations exist on the central venous catheter maintenance nor venous thrombosis prevention. The use of heparin flushes could be linked with long term complications, besides, anticoagulants use is controversial. OBJECTIVES: To be aware of the usual maintenance practice for HPN central venous catheters, catheter occlusion and related venous thrombosis incidence in our country...
January 2012: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
Carrie Sona, Donna Prentice, Lynn Schallom
BACKGROUND: Evidence is needed on the best solution for flushing central venous catheters. OBJECTIVE: To understand current flushing practices for short-term central venous catheters among critical care nurses before implementation of a randomized, controlled trial comparing physiological saline with heparin solution for flushing to maintain catheter patency. METHODS: A 6-item survey including demographic data was mailed to 2000 practicing critical care nurses in the United States...
February 2012: Critical Care Nurse
Sergio Bertoglio, Nicola Solari, Paolo Meszaros, Francesca Vassallo, Maura Bonvento, Simona Pastorino, Paolo Bruzzi
BACKGROUND: Heparin solution is routinely used to maintain the patency of infusion devices. Literature supports the alternative use of normal saline solution for flushing and locking intravenous infusion devices especially for pediatric patients. There is uncertainty regarding safety and efficacy of this policy for intermittent locking of implanted ports. OBJECTIVE: This study evaluates efficacy and safety of normal saline solution for intermittent locking procedures of implanted ports...
July 2012: Cancer Nursing
Sarah Simmons, Celestina Bryson, Susan Porter
This article reports the results of a study on the effect of alcohol disinfection duration on bacterial load on catheter hubs. Three different levels of disinfection (3, 10, and 15 seconds) were analyzed as well as a positive and negative control. All hubs with the exception of the negative controls were contaminated with a 10 bacterial solution and allowed to dry for 24 hours. Through each hub, 1 mL of sterile saline was flushed; a 10-μL calibrated loop was used to plate the flush onto blood agar. Colony counts were performed on the plates after a 24-hour incubation period...
January 2011: Critical Care Nursing Quarterly
Matthew D Mitchell, Barbara Jo Anderson, Kendal Williams, Craig A Umscheid
AIM: This paper is a report of a review to assess clinical studies comparing the effectiveness of different means of maintaining central venous catheter patency. BACKGROUND: Flushing with heparin is a routine part of central venous catheter maintenance, but it presents risks, including heparin-induced thrombocytopenia. Other techniques used to prevent occlusion of catheters include saline flushes, heparin-bonded catheters and pressure caps. DATA SOURCES: A search was conducted using the MEDLINE, CINAHL, EMBASE, Cochrane, National Guideline Clearinghouse and University Healthsystem Consortium databases...
October 2009: Journal of Advanced Nursing
Petra Wiersma, Sarah Schillie, Harry Keyserling, J Renee Watson, Anindya De, Shailendra N Banerjee, Cherie L Drenzek, Kathryn E Arnold, Christina Shivers, Lea Kendrick, Lydia Gonzalez Ryan, Bette Jensen, Judith Noble-Wang, Arjun Srinivasan
OBJECTIVE: To identify risk factors for polymicrobial bloodstream infections (BSIs) in pediatric bone marrow transplant (BMT) outpatients attending a newly constructed clinic affiliated with a children's hospital. METHODS: All 30 outpatients treated at a new BMT clinic during September 10-21, 2007, were enrolled in a cohort study. The investigation included interviews, medical records review, observations, and bacterial culture and molecular typing of patient and environmental isolates...
May 2010: Infection Control and Hospital Epidemiology
Simone Cesaro, Gloria Tridello, Mara Cavaliere, Laura Magagna, Patrizia Gavin, Riccardo Cusinato, Nicola Zadra, Giovanni Franco Zanon, Luigi Zanesco, Modesto Carli
PURPOSE: There are limited prospective data on whether the method of flushing affects the complication rate of tunnelled central venous catheters (CVCs). PATIENTS AND METHODS: 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. RESULTS: Two hundred twenty-one complications were recorded among 75,249 CVC-days (2...
April 20, 2009: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Christopher S Gamble, Kenneth O Jacobsen, Elizabeth K Leffel, M Louise M Pitt
Normal hematologic values for African green monkeys have been reported, but these results are confounded by the effect of chemical restraint (for example, ketamine), physical restraint, and capture stress. The dual-lumen central venous catheter, jacket, and tether combination we describe here allows intravenous fluid administration and repeated blood sampling without the use of anesthesia or inducing capture-related stress. The use of a low-concentration heparin solution for catheter maintenance significantly increased the mean patency time, compared with a saline-only catheter flush solution...
May 2007: Journal of the American Association for Laboratory Animal Science: JAALAS
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