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A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
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Published on: November 9, 2016

Treatment of catheter occlusion in pediatric patients

John A Kerner1, Manuel G Garcia-Careaga, Amy A Fisher

  • 1Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Stanford University Medical Center, Stanford, California 94304, USA. jkerner@stanfordmed.org

JPEN. Journal of Parenteral and Enteral Nutrition
|January 3, 2006
PubMed

Insights

Effective catheter occlusion management requires accurate assessment of thrombotic and nonthrombotic causes. Treatment varies, with positive-pressure devices showing promise for preventing future catheter occlusions.

Area of Science:

  • Medical Devices
  • Vascular Access
  • Clinical Management

Background:

  • Catheter occlusion is a common complication impacting patient care.
  • Accurate diagnosis of occlusion causes is essential for effective treatment.
  • Preventive strategies are crucial for maintaining central venous access device patency.

Purpose of the Study:

  • To outline diagnostic and therapeutic strategies for catheter occlusion.
  • To review current evidence on the prevention of catheter occlusion.

Main Methods:

  • Assessment differentiating thrombotic from nonthrombotic causes.
  • Treatment protocols based on identified occlusion etiology.
  • Review of prophylactic measures and device innovations.

Main Results:

  • Thrombotic occlusions treated with alteplase; nonthrombotic occlusions managed based on specific causes (e.g., ethanol for lipids, HCl for mineral/acidic drug precipitates, NaOH for basic drug precipitates).
  • No conclusive evidence supports heparin flushes over saline.
  • Positive-pressure devices demonstrate potential in reducing occlusion rates by preventing retrograde blood flow.

Conclusions:

  • Initial assessment guides successful catheter occlusion management.
  • Current prophylactic regimens lack strong scientific endorsement.
  • Positive-pressure devices represent a promising approach to decrease catheter occlusion rates.

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