IV Connector Virtual Tour

According to the 2008 IDSA/SHEA Compendium of Strategies to Prevent CLABSI, positive-pressure mechanical valves (PPMV) should not be routinely used as a part of CRBSI prevention efforts unless a thorough assessment of their risks, benefits, and education has been conducted.

The MaxPlus® Clear exhibits negative fluid displacement immediately upon connection. The repetitive blood reflux upon connection is a by-product of the moving part in the fluid pathway, typically a diaphragm or plunger-like valve, which compresses during connection, alters the chamber's volume and creates a vacuum, i.e. blood reflux.  Positive pressure (displacement) mechanical valves (PPMV) are largely believed to "clear" the catheter of blood and/or medications upon disconnection. But the real issue is one of blood fibrin development as repetitive cycles of blood reflux upon connection will condition the intraluminal catheter surfaces over time and affect catheter patency. More importantly, however, the internal moving part within PPMV typically creates a tortuous fluid pathway that complicates effective flushing.  Because of their higher priming volumes, PPMV have also shown a greater potential for biofilm development. PPMV have also been cited in the 2008 IDSA/SHEA Compendium and the VA Patient Advisory.  (See also, Cincinnati Children's Poster on MaxPlus®, White, Rupp).

The Clearlink® exhibits negative fluid displacement upon disconnection. Repetitive blood reflux upon disconnection, regardless of how minimal, will condition the intraluminal catheter surfaces over time and potentially affect catheter patency. Clamping sequence elimination combined with saline-only flushing should only be used in accordance with zero fluid displacement devices. Otherwise, the potential for intraluminal thrombotic catheter occlusions may persist.  The Clearlink® has also been associated with temporal increases in CRBSI (Jarvis, Jarvis) and may provide a less-than-optimal microbial barrier (Menyhay-Maki).  Because of its significantly higher priming volume, the Clearlink® may also carry a higher potential for biofilm adhesion potential and complicated flushing.  (Guy Cook)

The SmartSite® exhibits negative fluid displacement upon disconnection. Repetitive blood reflux upon disconnection, regardless of how minimal, will condition the intraluminal catheter surfaces over time and potentially affect catheter patency. Clamping sequence elimination combined with saline-only flushing should only be used in accordance with zero fluid displacement devices. Otherwise, the potential for intraluminal thrombotic catheter occlusions may persist.  The SmartSite® has also been associated with temporal increases in CRBSI (Jarvis, Jarvis, Salgado), and this is likely due to a combination of less-than-optimal design features, including a visible pre-slit which may harbor bacteria and inhibit surface disinfection, a single microbial barrier, and deadspace within the fluid pathway which may promote biofilm development and complicate effective flushing.

The Q-Syte™ exhibits negative fluid displacement upon disconnection. Repetitive blood reflux upon disconnection, regardless of how minimal, will condition the intraluminal catheter surfaces over time and potentially affect catheter patency. Clamping sequence elimination combined with saline-only flushing should only be used in accordance with zero fluid displacement devices. Otherwise, the potential for intraluminal thrombotic catheter occlusions may persist.  The Q-Syte™ carries an open fluid path.  The Q-Syte™ may provide a less-than-optimal microbial barrier due to the visible pre-slit septum surface, which may can harbor bacteria and complicate surface disinfection.  Click here to request the MD Anderson 10-Fold CRBSI Reduction poster.

According to the 2008 IDSA/SHEA Compendium of Strategies to Prevent CLABSI, positive-pressure mechanical valves (PPMV) should not be routinely used as a part of CRBSI prevention efforts unless a thorough assessment of their risks, benefits, and education has been conducted.

The Ultrasite® exhibits negative fluid displacement immediately upon connection. The repetitive blood reflux upon connection is a by-product of the moving part in the fluid pathway, typically a diaphragm or plunger-like valve, which compresses during connection, alters the chamber's volume and creates a vacuum, i.e. blood reflux.  Positive pressure (displacement) mechanical valves (PPMV) are largely believed to "clear" the catheter of blood and/or medications upon disconnection. But the real issue is one of blood fibrin development as repetitive cycles of blood reflux upon connection will condition the intraluminal catheter surfaces over time and affect catheter patency. Because of the internal moving part, PPMV are typically plagued by tortuous fluid pathways that complicate effective flushing.  Because of their higher priming volumes, PPMV have also shown a greater potential for biofilm development. PPMV have also been cited in the 2008 IDSA/SHEA Compendium and the VA Patient Advisory.  (See also, Jarvis, Jarvis, Cincinnati Children's Poster on MaxPlus®, White, Rupp).  The Ultrasite® also contains metal components, which may affect MRI compatibility.

According to the 2008 IDSA/SHEA Compendium of Strategies to Prevent CLABSI, positive-pressure mechanical valves (PPMV) should not be routinely used as a part of CRBSI prevention efforts unless a thorough assessment of their risks, benefits, and education has been conducted.

The CLC2000® exhibits negative fluid displacement immediately upon connection. The repetitive blood reflux upon connection is a by-product of the moving part in the fluid pathway, typically a diaphragm or plunger-like valve, which compresses during connection, alters the chamber's volume and creates a vacuum, i.e. blood reflux.  Positive pressure (displacement) mechanical valves (PPMV) are largely believed to "clear" the catheter of blood and/or medications upon disconnection. But the real issue is one of blood fibrin development as repetitive cycles of blood reflux upon connection will condition the intraluminal catheter surfaces over time and affect catheter patency. Because of the internal moving part, PPMV are typically plagued by tortuous fluid pathways that complicate effective flushing.  Because of their higher priming volumes, PPMV have also shown a greater potential for biofilm development. PPMV have also been cited in the 2008 IDSA/SHEA Compendium and the VA Patient Advisory.  (See also, Cincinnati Children's Poster on MaxPlus®, White, Rupp, Field).  The CLC2000® also contains metal components, which may affect MRI compatibility.