Key result
Needleless connectors with integrated anti-reflux technology significantly reduced reflux volume compared to devices without anti-reflux technology (0.27 µL vs 4.15 µL, P<0.0001).
Why the study?
Marketing terms do not adequately describe needleless connector function and performance, causing confusion and poor understanding of correct flush-clamp-disconnect sequences.
Do needleless connectors with integrated anti-reflux technology reduce reflux volume and control bi-directional fluid movement compared to those without anti-reflux technology in an in vitro model?
Do needleless connectors with integrated anti-reflux technology reduce reflux volume and control bi-directional fluid movement compared to those without anti-reflux technology in an in vitro model?
Absolute Event Rate: 0.27% vs 4.15%
p-value: p=<0.0001
In vitro testing demonstrates that needleless connectors with integrated anti-reflux technology significantly reduce fluid reflux volume and control bi-directional fluid movement compared to standard connectors, potentially reducing the risk of catheter occlusion and infection.
Anti-reflux NCs minimize reflux in vitro; leaves open whether they reduce clinical occlusion or infection risk.
Design, function, and performance vary between negative displacement, positive displacement and pressure-activated antireflux needleless connectors (NCs). Marketing terms used to classify needleless connectors do not adequately describe function and performance, leading to confusion and poor understanding of the correct flush-clamp-disconnect sequence specific to each NC design. We compared commercially available NCs without integrated anti-reflux technology to their exact design counterpart with anti-reflux technology. The goal of this study was to evaluate each NC's ability to control bi-directional fluid movement caused by mechanical and physiological pressure changes and measure reflux volume. A venous simulator was used to measure and visualize fluid displacement associated with each NCs design upon connection and disconnection of a syringe. A bi-directional flow test was also performed by creating a pressure gradient between two reservoirs which were connected using the NC being tested. The fluid displacement at syringe disconnection was negative for all devices tested. All NCs with integrated anti-reflux technology significantly reduced the reflux volume compared to their design counterparts without anti-reflux technology (P < .0001). The difference in reflux volume was statistically significant (P < .0001) between all NC devices with integrated anti-reflux technology (0.27L; 95% CI 0.21-0.34L) compared to all devices without anti-reflux technology (4.15L; 95% CI 3.76-4.54L). All NCs without anti-reflux technology failed to demonstrate the ability to control blood reflux and bi-directional fluid movement. These results demonstrate that integrated anti-reflux technology is effective at preventing blood reflux caused by mechanical and physiological pressure changes in a closed IV system.
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Hughey et al. (2023) studied In vitro evaluation of needleless connectors. Needleless connectors with integrated anti-reflux technology vs. Needleless connectors without anti-reflux technology was evaluated on Reflux volume at syringe disconnection (p=<0.0001). Needleless connectors with integrated anti-reflux technology significantly reduced reflux volume compared to devices without anti-reflux technology (0.27 µL vs 4.15 µL, P<0.0001).
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