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Central venous catheter occlusion: a prospective, controlled trial examining the impact of a positive-pressure valve

Brian R Jacobs1, Susan Schilling, Darcy Doellman

  • 1Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA. jacobs@chmcc.org

JPEN. Journal of Parenteral and Enteral Nutrition
|April 15, 2004
PubMed

Insights

Using a positive pressure valve device significantly reduced complete central venous catheter (CVC) occlusion in children compared to standard devices. This innovation improves CVC management and reduces therapy disruptions.

Area of Science:

  • Pediatric critical care
  • Vascular access devices
  • Medical device innovation

Background:

  • Central venous catheter (CVC) occlusion is a common complication in pediatric patients, disrupting essential therapy and monitoring.
  • Blood reflux into the catheter lumen is a frequent contributor to CVC occlusion.
  • Current management strategies for CVC occlusion often lead to treatment delays.

Purpose of the Study:

  • To evaluate the efficacy of a positive-pressure valve device in reducing central venous catheter occlusion in children.
  • To compare the incidence of complete and partial catheter occlusions between positive-pressure valve devices and standard cap devices.
  • To assess user satisfaction with the positive-pressure valve device.

Main Methods:

  • A sequential study design was employed, comparing standard CVC caps (Phase I) with positive-pressure valve caps (Phase II).
  • Data included patient demographics, catheter type, duration, and complications, with specific delineation of partial and complete occlusions.
  • A user satisfaction survey was conducted to gather qualitative feedback.

Main Results:

  • The study enrolled 153 children with 312 CVC lumens; mean catheter duration was 9.4 days.
  • Complete CVC occlusions were significantly lower with the positive-pressure valve device (3.7%) compared to the standard device (11.9%) (p = .012).
  • No significant differences were observed in partial occlusions, phlebitis, or catheter-related bloodstream infections between the groups.

Conclusions:

  • Positive-pressure valve cap devices demonstrate a reduced incidence of complete central venous catheter occlusion in pediatric patients.
  • This device offers a promising solution for improving the reliability of central venous catheters in children.
  • Further research may explore long-term efficacy and broader clinical applications.
Abstract

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