Application of sodium bicarbonate solution for flushing to prevent fibrin sheath blockage of peripherally inserted central catheter
10.3760/cma.j.cn211501-20240402-00767
- VernacularTitle:碳酸氢钠溶液封管预防经外周静脉置入中心静脉导管纤维蛋白鞘堵塞的应用研究
- Author:
Daiqi JIANG
1
;
Guoyu DENG
1
;
Lingling LI
1
;
Rongqing LI
1
Author Information
1. 广西医科大学附属肿瘤医院头颈放疗二病区，南宁 530021
- Publication Type:Journal Article
- Keywords:
Catheterization, central venous;
Sodium bicarbonate;
Interleukin-6;
Flushing solution;
Fibrin sheath;
Catheter occlusion;
Blood bicarbonate
- From:
Chinese Journal of Practical Nursing
2025;41(10):749-753
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the feasibility and safety of sodium bicarbonate solution for flushing in preventing fibrin sheath occlusion in peripherally inserted central catheters (PICC), providing a reference for PICC maintenance.Methods:A randomized controlled study was conducted from June 2022 to September 2023. Convenience sampling was used to select 96 patients who underwent PICC at the Affiliated Tumor Hospital of Guangxi Medical University. The patients were randomly divided into a control group and an observation group. Both groups performed grip strength exercises using a grip ball on the catheterized upper limb. During catheter maintenance, both groups used 10 ml of 0.9% sodium chloride solution for pulsed flushing. The control group used 10 ml of 0.9% sodium chloride solution for positive pressure flushing, while the observation group used 3 ml of 5% sodium bicarbonate solution for positive pressure flushing. The incidence of "mechanical valve" and catheter occlusion, as well as blood bicarbonate concentration and interleukin-6 (IL-6) levels, were recorded on the first day and at 1, 2, 3, 4, and 5 months after catheterization.Results:A total of 92 PICC patients were included, with 45 in the control group, 28 males and 17 females, aged (43.80 ± 2.21) years old, and 47 in the observation group, 29 males and 18 females, aged (43.80 ± 2.25) years old. The total incidence of "mechanical valve" in the observation group was 2.1% (1/47), lower than the control group′s 26.7% (12/45), the difference was statistically significant ( χ2=11.41, P<0.05). The incidence of catheter occlusion in the observation group was 2.1% (1/47), lower than the control group's 15.5% (7/45), the difference was statistically significant ( χ2=5.22, P<0.05). The IL-6 levels in the observation group at 2, 3, 4, and 5 months after catheterization were (4.53 ± 0.62), (4.68 ± 0.59), (4.76 ± 0.57), and (4.83 ± 0.53) ng/L, respectively, lower than the control group (4.83 ± 0.59), (4.95 ± 0.54), (5.21 ± 0.48), and (5.63 ± 0.57) ng/L, the differences were statistically significant ( t values were 2.26-6.86, all P<0.05). There were no significant differences in blood bicarbonate concentration between the two groups at different time points (all P>0.05). Conclusions:Sodium bicarbonate solution for flushing can effectively prevent fibrin sheath blockage of PICC and reduce serum IL-6 levels, making it a safe and effective flushing method.
