Central venous catheters (CVCs) are vital for the care of hospitalized and critically ill patients, as they provide reliable venous access for clinical activities such as infusion of medications, hemodynamic measurement and blood sampling. However, CVCs are also the leading cause of healthcare-associated bloodstream infections (BSI) frequently implicated in life-threatening illnesses.
Hub colonization and intraluminal migration of infection have both been recognized to be a common cause of intravascular catheter-related bloodstream infections in short- and long-term central venous catheters.
Stopcocks (used for injection of medications, administration of IV infusions, and collection of blood samples) represent a potential portal of entry for microorganisms into vascular access catheters and IV fluids. Stopcock contamination is common, occurring in 45% and 50% in the majority of series.
Healthcare Infection Control Practices Advisory Committee (HICPAC) and Center for Disease Control (CDC) guidelines state that stopcocks should be capped when not being used and injection ports should be cleaned with 70% alcohol or an iodophor before accessing the system. In general, closed catheter access systems are associated with fewer CRBSIs than open systems and should be used preferentially.
In the practice of Peripheral Arterial Catheters and Pressure Monitoring Devices the CDC recommends to minimize the number of manipulations of and entries into the pressure monitoring system. Use a closed-flush system (i.e., continuous flush), rather than an open system (i.e., one that requires a syringe and stopcock), to maintain the patency of the pressure monitoring catheters.
Meeting the Challenge
Elcam's MarvelousTM stopcock (MRVLS) is the first minimal residual volume luer-activated stopcock that was designed to increase patient safety relative to infection prevention.
The Marvelous two main features both promote infection control:
The luer-activated valve (LAV) serves as a bacterial barrier, allowing access to the line without opening it and thereby maintaing a closed system that reduces bacterial ingress and consequent microbial contamination.
The fluid flow around the handle creates a unique “circumferential channel” that reaches the entire internal volume of the valve. Constant flushing of the side port with (main line) carrier fluid minimizes dead space and prevents stagnation, which, based on the results of several studies, can reduce the risk of bacterial colonization.
Marvelous further improves infection control by enabling fewer manipulations with the elimination of post-medication/ blood sampling flushing with a syringe and the use of ad-on caps.