Safety of Catheter Lock With or Without Heparin in Implanted Central Venous Catheters

NCT ID: NCT00994136

Last Updated: 2011-06-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

1100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-01-31

Study Completion Date

2011-06-30

Brief Summary

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Long-term central venous access devices are considered as safe for the administration of medication as chemotherapy, but are also used for blood sampling. For years these catheters have been locked with a heparin solution in order to avoid occlusion. However, no scientific evidence supports heparin locking when the device is not in use. Advanced technology as needleless caps and valved catheters and port reservoirs confirms this trend to use 'saline only' for locking these devices. Therefore the investigators hypothesize is that there will be no difference in proportion of occlusions and catheter related bacteremia in long-term venous access devices locked with 'saline only' versus with heparin.

Detailed Description

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Conditions

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Oncology, Medical Hematologic Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Normal saline

In the intervention group the use of heparin as locking solution in the catheter lumen (or lumina) when the catheter is not longer in use is omitted. Catheters are locked under positive pressure with normal saline in stead injecting an extra volume of heparinised saline (100IU/ml).

Group Type EXPERIMENTAL

normal saline

Intervention Type DRUG

Ten milliliters of normal saline will be injected at the end of the intravenous therapy. Injection is performed with the start/stop method and with the positive pressure technique (clamping the catheter while injecting the last milliliters of normal saline)

Heparin lock

Group Type NO_INTERVENTION

normal saline

Intervention Type DRUG

Ten milliliters of normal saline will be injected at the end of the intravenous therapy. Injection is performed with the start/stop method and with the positive pressure technique (clamping the catheter while injecting the last milliliters of normal saline)

Interventions

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normal saline

Ten milliliters of normal saline will be injected at the end of the intravenous therapy. Injection is performed with the start/stop method and with the positive pressure technique (clamping the catheter while injecting the last milliliters of normal saline)

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Oncology and hematology patients
* Life expectancy of minimum of 180 days

Exclusion Criteria

* second or femoral long-term central venous access device
* known allergy to heparin (HIT)
* coagulation disorders(INR \>2, Blood platelets \> 1,000,000/mm3)
* therapeutic intravenous heparin administration
Minimum Eligible Age

1 Year

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Leuvens Kanker Instituut

UNKNOWN

Sponsor Role collaborator

Universitaire Ziekenhuizen KU Leuven

OTHER

Sponsor Role lead

Responsible Party

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Universitaire Ziekenhuizen Leuven

Principal Investigators

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Marguerite Stas, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Universitaire Ziekenhuizen KU Leuven

Locations

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Universitaire Ziekenhuizen Leuven

Leuven, Vlaams-Brabant, Belgium

Site Status

Countries

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Belgium

References

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Stephens LC, Haire WD, Tarantolo S, Reed E, Schmit-Pokorny K, Kessinger A, Klein R. Normal saline versus heparin flush for maintaining central venous catheter patency during apheresis collection of peripheral blood stem cells (PBSC). Transfus Sci. 1997 Jun;18(2):187-93. doi: 10.1016/s0955-3886(97)00008-8.

Reference Type BACKGROUND
PMID: 10174683 (View on PubMed)

Kadidal VV, Mayo DJ, Horne MK. Heparin-induced thrombocytopenia (HIT) due to heparin flushes: a report of three cases. J Intern Med. 1999 Sep;246(3):325-9. doi: 10.1046/j.1365-2796.1999.00527.x.

Reference Type BACKGROUND
PMID: 10476001 (View on PubMed)

Rama BN, Haake RE, Bander SJ, Ghasem-Zadeh A, Gorla C. Heparin-flush associated thrombocytopenia--induced hemorrhage: a case report. Nebr Med J. 1991 Dec;76(12):392-4.

Reference Type BACKGROUND
PMID: 1784321 (View on PubMed)

Bazelly B, Lotz JP, Milleron B. [The maintenance of totally implantable perfusion sites]. Rev Pneumol Clin. 1994;50(1):43-4. No abstract available. French.

Reference Type BACKGROUND
PMID: 7973333 (View on PubMed)

Randolph AG, Cook DJ, Gonzales CA, Andrew M. Benefit of heparin in peripheral venous and arterial catheters: systematic review and meta-analysis of randomised controlled trials. BMJ. 1998 Mar 28;316(7136):969-75. doi: 10.1136/bmj.316.7136.969.

Reference Type BACKGROUND
PMID: 9550955 (View on PubMed)

Theard JL, Robard S. [Outcome of usage protocols on implantable devices]. Ann Fr Anesth Reanim. 1995;14(6):534-5. doi: 10.1016/s0750-7658(05)80501-5. No abstract available. French.

Reference Type BACKGROUND
PMID: 8745984 (View on PubMed)

Smith S, Dawson S, Hennessey R, Andrew M. Maintenance of the patency of indwelling central venous catheters: is heparin necessary? Am J Pediatr Hematol Oncol. 1991 Summer;13(2):141-3. doi: 10.1097/00043426-199122000-00005.

Reference Type BACKGROUND
PMID: 2069221 (View on PubMed)

Brown-Smith JK, Stoner MH, Barley ZA. Tunneled catheter thrombosis: factors related to incidence. Oncol Nurs Forum. 1990 Jul-Aug;17(4):543-9.

Reference Type BACKGROUND
PMID: 2399167 (View on PubMed)

Kelly C, Dumenko L, McGregor SE, McHutchion ME. A change in flushing protocols of central venous catheters. Oncol Nurs Forum. 1992 May;19(4):599-605.

Reference Type BACKGROUND
PMID: 1603675 (View on PubMed)

Goossens GA, Verbeeck G, Moons P, Sermeus W, De Wever I, Stas M. Functional evaluation of conventional 'Celsite' venous ports versus 'Vortex' ports with a tangential outlet: a prospective randomised pilot study. Support Care Cancer. 2008 Dec;16(12):1367-74. doi: 10.1007/s00520-008-0436-y. Epub 2008 Apr 15.

Reference Type BACKGROUND
PMID: 18414904 (View on PubMed)

McDiarmid S, Hamelin L, Huebsch LB. Leading change: Retrospective evaluation of a nurse-led initiative in vascular access options for autologous stem cell transplant recipients ranging from Hickman catheters to peripherally inserted central catheters. J Infus Nurs. 2006 Mar-Apr;29(2):81-8. doi: 10.1097/00129804-200603000-00005.

Reference Type BACKGROUND
PMID: 16569997 (View on PubMed)

Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008 Jun;36(5):309-32. doi: 10.1016/j.ajic.2008.03.002. No abstract available.

Reference Type BACKGROUND
PMID: 18538699 (View on PubMed)

Caers J, Fontaine C, Vinh-Hung V, De Mey J, Ponnet G, Oost C, Lamote J, De Greve J, Van Camp B, Lacor P. Catheter tip position as a risk factor for thrombosis associated with the use of subcutaneous infusion ports. Support Care Cancer. 2005 May;13(5):325-31. doi: 10.1007/s00520-004-0723-1. Epub 2004 Nov 5.

Reference Type BACKGROUND
PMID: 15538639 (View on PubMed)

Petersen J, Delaney JH, Brakstad MT, Rowbotham RK, Bagley CM Jr. Silicone venous access devices positioned with their tips high in the superior vena cava are more likely to malfunction. Am J Surg. 1999 Jul;178(1):38-41. doi: 10.1016/s0002-9610(99)00124-5.

Reference Type BACKGROUND
PMID: 10456700 (View on PubMed)

Brouns F, Schuermans A, Verhaegen J, De Wever I, Stas M. Infection assessment of totally implanted long-term venous access devices. J Vasc Access. 2006 Jan-Mar;7(1):24-8. doi: 10.1177/112972980600700105.

Reference Type BACKGROUND
PMID: 16596525 (View on PubMed)

Hadaway LC. Flushing to reduce central catheter occlusions. Nursing. 2000 Oct;30(10):74. doi: 10.1097/00152193-200030100-00037. No abstract available.

Reference Type BACKGROUND
PMID: 11096978 (View on PubMed)

Ryder M. The role of biofilm in vascular catheter-related infections. 15-25. 2001. Ref Type: Serial (Book,Monograph)

Reference Type BACKGROUND

Cossey V, Thelissen MJ, Goossens GA, Stas M, Schuermans A. Needleless positive-pressure mechanical valve connectors: are they safe? Clin Microbiol Infect 2008;S121-666.doi:10.1111/j.1469-0691.2008.02007.x.

Reference Type BACKGROUND

Other Identifiers

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SM008

Identifier Type: -

Identifier Source: org_study_id

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