Most recently, a three-month prospective observational
study was conducted by OhioHealth in Columbus, Ohio during
the fall of 2006 (Jasinsky & Wurster, 2009). During the first
month of the study, data was collected on the rate of occlusions
in peripheral IV catheters, central venous catheters (triple lumen,
subclavian, or internal jugular), and peripherally inserted
central catheters (PICCs). The standard of care during the first
month of the study was to flush the central venous catheters and
PICCs with heparin 100 units/ml every 12 hours. All catheters
had a luer-activated device mechanical valve (MV). The PICCs
were non-tunneled and open-ended. During the second month
of the study, an anti-reflux valve was attached to the MV. Heparin
flushes were replaced with 10-ml normal saline flushes during
the third month of the study. A total of 189 patients with
central venous catheters and PICCs were included. Occlusion
rates decreased significantly during month two, demonstrating
efficacy of the anti-reflux valve. Although the occlusion
rates increased slightly from month two to month three with the
elimination of heparin, occlusion rates were still significantly
less than month one. Thus, saline flushes were determined to be
a safe alternative to heparin (Jasinsky & Wurster, 2009)