From the Guidelines
Irrigating a catheter with saline is the most recommended approach to prevent central venous catheter occlusion and restore catheter patency in intra-lumen catheter occlusion. The most recent and highest quality study, published in 2021, suggests flushing catheters with saline to prevent central venous catheter occlusion 1. Additionally, irrigation of the catheter with saline is recommended as the first attempt to restore catheter patency in intra-lumen catheter occlusion 1.
Some key points to consider when irrigating a catheter include:
- Using normal saline (0.9% sodium chloride) at room temperature
- Maintaining sterile technique to prevent infection
- Using gentle pressure to avoid tissue damage
- Ensuring proper drainage to prevent fluid buildup
- Irrigation may be continuous or intermittent depending on the clinical situation
It is also important to note that fibrinolytic drugs, such as urokinase and alteplase, may be used for the treatment of acute catheter occlusion likely caused by blood clotting 1. However, saline irrigation is the first line of treatment and should be attempted before using fibrinolytic drugs.
Overall, proper irrigation technique helps maintain catheter patency and reduces complications like infections or blockages. It is essential to follow the most recent and highest quality guidelines, such as those published in 2021, to ensure the best possible outcomes for patients with catheters 1.
From the Research
Irrigating Catheter Overview
- The use of antimicrobial irrigation solutions for prevention and treatment of urinary tract infections in catheterized patients has been reviewed 2.
- Prophylactic continuous irrigation with various solutions has been demonstrated to be effective in decreasing the incidence of bacteriuria in open catheter drainage systems, especially for 10 days or less following catheter insertion 2.
- However, prophylactic irrigation of closed catheter systems has not been demonstrated to prevent bacteriuria 2.
Types of Irrigation Solutions
- Different irrigating solutions have been studied, including saline, acetic acid, chlorhexidine, and silver nitrate 3.
- Chlorhexidine and silver nitrate have been shown to effectively reduce bacterial counts in urine samples, but chlorhexidine is preferable due to fewer side effects and greater convenience 3.
- However, another study found no statistical difference between the antimicrobial effect of chlorhexidine and saline in an animal model 4.
Best Practices for Bladder Irrigation
- Bladder irrigation is performed to restore or maintain the patency of an indwelling urinary catheter, and best practices for this procedure have been outlined 5.
- Strict adherence to proper catheter care procedures is the most important factor in reducing catheter infection rates 2.
- Routine catheter flushing before and after infusion, as well as at the end of use, is necessary to prevent occlusions 6.
Comparison of Heparin and Normal Saline
- The effectiveness of heparin versus normal saline in locking central venous catheters has been evaluated, and no evidence was found that heparin was more effective in reducing complications such as occlusion, catheter-related infections, and thrombosis 6.
- Heparin is not superior compared to normal saline in reducing catheter occlusion 6.