LOCK METHOD USING SODIUM-HYDROXIDE SOLUTION TO CLEAR OCCLUDED CENTRALVENOUS ACCESS DEVICES

Occlusion of central venous access devices (CVADs) is not an uncommon problem during long-term parenteral nutrition. A number of techniques have been developed to deal with obstructed CVADs. This study investig ated the effectiveness of the sodium hydroxide (NaOH) lock method for gradual CVAD occlusion. When a progressively declining flow was notice d, 0.1N NaOH solution was injected into the CVAD and locked. Nineteen CVAD occlusions in 11 home parenteral nutrition patients were treated. Sixteen of 19 trials cleared the occlusions, whereas 3 of 19 failed. One of the failures was due to a mechanical occlusion and the other tw o were able to be restored by using ethanol. There were no significant complications. The benefits of this method are: (1) a shorter treatme nt time and a lower dose than NaOH infusion therapy, (2) it does not r equire hospital admission and (3) it does not result in bursting of th e catheter.