CLEAN3 trial outlines potential new best practices for peripheral IV catheters

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BD today announced that new clinical data have found robust evidence that using a vascular care solution can help improve outcomes for patients requiring peripheral intravenous catheters (PIVCs).

Results of the CLEAN3 trial, published in The Lancet Infectious Diseases, showed that use of the BD vascular care solution resulted in fewer PIVC failures compared with the standard group (34.8% vs. 47.5%, respectively) and extended the median time between catheter insertion and failure (50.4 hours vs. 30 hours, respectively). PIVC failure was defined as any premature removal of PIVC before end of treatment—other than for routine replacement—and included phlebitis, infiltration, occlusion, dislodgment, local infection and catheter-related bloodstream infection (whichever occurred first).

The CLEAN3 trial also evaluated skin antiseptics with 2% chlorhexidine-gluconate (CHG) 70% isopropyl alcohol (IPA) single use, sterile applicator versus 5% povidone iodine (PVI) 69% ethanol applied with sterile gauze in preventing infectious complications related to the use of PIVCs (catheter colonisation: 0.9% vs. 16.9%, respectively; local infection: 0% vs. 1.2%, respectively).

The trial, which involved approximately 1,000 patients from nine different medical wards within a single university hospital (Poitiers University Hospital, France), evaluated PIVC failure rates by comparing the BD vascular care solution for PIVCs, which included an integrated PIVC (BD Nexiva), a positive displacement needle-free connector (BD MaxZero), a disinfecting cap (BD PureHub) and a sterile prefilled flush syringe (BD PosiFlush)—compared with a standard group, which included a straight safety PIVC (BD Insyte Autoguard BC Winged), extension set three-way stopcock; the PIVCs were continuously infused with saline or polyionic solution, by gravity.

“The findings of the CLEAN3 trial support the use of an integrated solution as the best practice standard when peripheral IV catheter dwell time is expected to exceed 24 hours,” said Olivier Mimoz (Poitiers University Hospital, Poitiers, France), principal investigator of the CLEAN3 trial. “Furthermore, the study shows that the use of 2% CHG-70% IPA single use, sterile applicator should become the first-line antiseptic for skin disinfection prior to PIVC insertion. We believe that the results can be extrapolated to all adult patients admitted to a medical ward requiring a PIVC placement and, by extrapolation, to those admitted to a surgical ward.”


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