National survey of central venous catheter flushing in the intensive care unit

Abstract

Background: Evidence is needed on the best solution for flushing central venous catheters.

Objective: To understand current flushing practices for short-term central venous catheters among critical care nurses before implementation of a randomized, controlled trial comparing physiological saline with heparin solution for flushing to maintain catheter patency.

Methods: A 6-item survey including demographic data was mailed to 2000 practicing critical care nurses in the United States. An additional 316 surveys were completed at the annual conference of the American Association of Critical-Care Nurses.

Results: Most (71.5%) of the 632 respondents who completed the survey were staff nurses. Most respondents (64.6%; 95% CI, 60.86%-68.34%) reported using physiological saline exclusively to flush central venous catheters and maintain patency. For heparin-containing solutions, the concentration and volume used varied. The most commonly reported volumes for flushing were 10 mL for saline (63%; 95% CI, 59.18%-66.82%) and 3 mL for heparin (50.2%; 95% CI, 43.5%-56.9%).

Conclusion: Flushing practices for central venous catheters vary widely. A randomized controlled trial is needed to determine the optimal flushing solution to maintain short-term patency.