Table of Contents Author Guidelines Submit a Manuscript
Nursing Research and Practice
Volume 2015, Article ID 985686, 12 pages
http://dx.doi.org/10.1155/2015/985686
Review Article

Flushing and Locking of Venous Catheters: Available Evidence and Evidence Deficit

1Nursing Centre of Excellence, University Hospitals Leuven, 3000 Leuven, Belgium
2Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium

Received 12 November 2014; Accepted 24 February 2015

Academic Editor: Lisa Dougherty

Copyright © 2015 Godelieve Alice Goossens. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Flushing and locking of intravenous catheters are thought to be essential in the prevention of occlusion. The clinical sign of an occlusion is catheter malfunction and flushing is strongly recommended to ensure a well-functioning catheter. Therefore fluid dynamics, flushing techniques, and sufficient flushing volumes are important matters in adequate flushing in all catheter types. If a catheter is not in use, it is locked. For years, it has been thought that the catheter has to be filled with an anticoagulant to prevent catheter occlusion. Heparin has played a key role in locking venous catheters. However, the high number of risks associated with heparin forces us to look for alternatives. A long time ago, 0.9% sodium chloride was already introduced as locking solution in peripheral cannulas. More recently, a 0.9% sodium chloride lock has also been investigated in other types of catheters. Thrombolytic agents have also been studied as a locking solution because their antithrombotic effect was suggested as superior to heparin. Other catheter lock solutions focus on the anti-infective properties of the locks such as antibiotics and chelating agents. Still, the most effective locking solution will depend on the catheter type and the patient’s condition.