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Prevention, Assessment, and Treatment of Central Venous Catheter Occlusions in Neonatal and Young Pediatric Patients

Doellman, Darcy BSN, RN, CRNI®

doi: 10.1097/NAN.0b013e31821da2ae
Features

Central venous catheter occlusions disrupt delivery of needed therapies to vulnerable neonatal and young pediatric patients. Nursing practices that minimize risk of catheter occlusion include proper infusion and flushing techniques. Treatment strategies vary on the basis of the source of the occlusion. Mechanical occlusions can often be resolved by altering the patient's position, correcting catheter kinks, or adjusting clamps. Occlusions caused by precipitation can be cleared through instillation of ethanol, hydrochloric acid, or sodium bicarbonate, depending on the chemistry of the infusates. Finally, the thrombolytic agent alteplase is recommended for treatment of catheter occlusion because of thrombus formation.

Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

Corresponding Author: Darcy Doellman, BSN, RN, CRNI®, Cincinnati Children's Hospital, 3333 Burnet Ave, Cincinnati, OH 45229 (darcy.doellman@fuse.net or darcy.doellman@cchmc.org).

Darcy Doellman is a neonatal and pediatric vascular access nurse at Cincinnati Children's Hospital. Her responsibilities include insertion of peripherally inserted central catheters, troubleshooting central catheter complications, and providing staff education. Darcy has published and spoken extensively on her research outcomes as well as other topics related to vascular access.

Support for assistance with third-party medical writing was provided by Genentech, Inc. The author is on the Speaker's Bureau for Genentech and 3M and serves as a consultant for Teleflexmedical/Arrow International.

© Copyright 2011 by the Infusion Nurses Society