Observational Experiment of Catheter Reflux During Huber Needle Withdrawal In Two Countries

Abstract

Introduction: Over the past 30 years, the use of implanted vascular access devices (IVAD) for long-term administration of vesicants, parenteral nutrition, blood products, and antimicrobials has grown exponentially. IVADs are a vital part of patient care, improve quality of life, and help with body image. Despite the positive aspects of IVAD, complications can still occur, one of which is device occlusion as a result of blood reflux. Methods: This observational experiment was conducted in the United Kingdom and the United States. The investigators in each country tested six Huber needles and measured the fluid reflux in the IVAD catheter upon removal of each Huber. This simple experiment was done using an in vitro port with a six French catheter secured to a ruler to measure fluid reflux into the port catheter upon removal of the six available Huber needles. Six commercially available Huber needles were each tested unclamped and clamped three times upon removal; the average was then calculated. Results: The findings demonstrated fluid reflux volumes with the six Hubers ranging from 0.0 to 0.6 cm unclamped and 0.0 to 0.7 cm of fluid reflux with the Hubers clamped. Only one Huber had no fluid reflux during needle withdrawal from the IVAD without clamping the tubing and with the tubing clamped. Five of the Hubers had fluid reflux during removal when unclamped and clamped. Conclusions: This experiment confirmed and revealed the differences in fluid reflux when removing a Huber needle from a port unclamped and clamped. Highlighted was the need for further research on fluid reflux and the potential impact it has on port occlusions. This experiment demonstrated that positive pressure needle withdrawal reduced reflux, compared to positive pressure flushing. Understanding the reflux associated with each Huber needle when de-accessing a port can potentially reduce port occlusions subsequently, improving patient outcomes.