Key result
Positive displacement needle-free connectors showed lower backflow volume (0.83 mm3) compared to Q-SYTE (1.14 mm3), Neutron (1.27 mm3), and Bionector (1.24 mm3) when used with PICC in a bench study.
Why the study?
This study aimed to evaluate backflow volume when different needle-free connector categories and clamping sequences are used with a peripherally inserted central catheter and a Midline catheter.
Do different needle-free connector categories and clamping sequences affect backflow volume in PICC and Midline catheters in a bench model?
Do different needle-free connector categories and clamping sequences affect backflow volume in PICC and Midline catheters in a bench model?
In a bench model, no needle-free connector eliminated backflow volume, but positive displacement connectors showed lower reflux when used with PICCs.
Bench data on lower reflux with positive displacement connectors should not yet change practice; leaves open clinical impact on PICC patency.
Background: Needle-free connectors (NFCs) are closure systems for vascular catheters largely used because effectively reduce needlestick incidents. They are classified based on their impact on the fluid column within the catheter as positive (fluid displacement into the vein), negative (fluid displacement back from the vein into the catheter), neutral (minimal displacement), or anti-reflux (equipped with additional anti-reflux valve). Each category has specific usage and clamping procedures. This study aimed to evaluate the backflow volume (BV) when different NFC categories and clamping sequences are used with a peripherally inserted central catheter (PICC) and a Midline catheter (MC). Methods: In this bench study, four types of NFCs with different flow displacement behavior were studied. Each NFC was evaluated using two different catheters: a 4 Fr × 60 cm single-lumen catheter (PICC), and a 4 Fr × 25 cm single-lumen catheter (MC). The experimental model simulated the physiological blood pressure of the superior vena cava. Three operators performed specific sealing sequences for each combination of NFC and catheter. After that, the BV (mm 3 ) inside the catheter for every NFC was assessed. Results: None of the four NFCs was able to avoid the BV into the catheter. Positive NFC showed a lower BV as compared to the other three NFCs when tested with PICC: 0.83 [0.76–0.95] mm 3 versus 1.14 [0.95–1.53] mm 3 of Q-SYTE, versus 1.27 [1.02–1.59] mm 3 of Neutron, versus 1.24 [0.95–1.84] mm 3 of Bionector, whereas no differences were observed when tested with Midline. No differences were observed between different clamping sequences when used with neutral and anti-reflux NFCs. Conclusion: This study examined the performance of various NFC technologies with PICC and Midline. While no device eliminates BV, positive displacement NFCs showed lower flow reflux compared to the others when used with PICC. No difference between clamping sequences was observed for neutral and anti-reflux NFCs.
No takes yet. Share an insight, caveat, or question.
Privitera et al. (2025) studied this question. Positive displacement needle-free connectors vs. Q-SYTE, Neutron, and Bionector NFCs was evaluated on Backflow volume (BV) inside the catheter. Positive displacement needle-free connectors showed lower backflow volume (0.83 mm3) compared to Q-SYTE (1.14 mm3), Neutron (1.27 mm3), and Bionector (1.24 mm3) when used with PICC in a bench study.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: