The recent guideline concluded that routine flushing with NS is recommended. Most of these studies indicate that normal saline (NS) is safe and efficacious in preventing catheter occlusion in adult populations with CVCs. There have been numerous publications in this field over the last few years, including a guideline, several trials and several reviews, including a Cochrane Review. Especially important, if there was a suitable replacement for HS, that would be beneficial, especially for patients with contraindications to using HS. Researchers have been looking for a safe alternative to heparin, such as isotonic saline, vitamin C, lepirudin, sodium citrate or polygeline, to improve this situation. Moreover, the use of heparinised saline is associated with potential risks such as coagulation disorders, hypersensitivity reactions and heparin-induced thrombocytopenia (HIT). Nonetheless, the efficacy of this practice has not been definitively shown. Thus, heparin is widely used to maintain the patency of CVCs. Unfractionated heparin is well-known for its anticoagulant activity. To avoid the risk of catheter occlusion, thrombosis and catheter-related bloodstream infection (CRBSI), proper catheter flushing and locking are always considered to be the primary intervention because of the effect of reducing blood reflux into the lumen. Factors leading to catheter obstruction can be generally classified into three categories: mechanical causes, drug/mineral precipitates and clot formation, which is the most common reason overall. It is estimated that the occlusion rate is between 0% and 33% when using heparin saline (HS) solution. Generally, catheter obstruction can be defined as partial occlusion (inability to aspirate blood but ability to flush freely) or complete occlusion (inability to flush freely and withdraw blood). Inserting a new central line creates latent threats, which could lead to disrupted treatment, increasing morbidity, and greater spending on health care. Prolonged use may result in catheter occlusion, which may give rise to a requirement for the catheter to be treated, removed or replaced. These central lines will remain in place for days or even weeks each time. Currently, there are four types of CVCs: non-tunneled, tunneled, peripherally nserted central catheters (PICCs) and totally implantable venous access devices (TIVADs). These devices are inserted so as to enable the administration of fluids, blood products, medications, parenteral nutrition, and for the performance of dialysis and central venous pressure monitoring.
Central venous catheters (CVCs) are widely utilized in clinical practice, especially in intensive care units (ICUs).
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