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Do catheter washouts extend patency time in long-term indwelling urethral catheters? A randomized controlled trial of acidic washout solution, normal saline washout, or standard care.

Do catheter washouts extend patency time in long-term indwelling urethral catheters? A randomized controlled trial of acidic washout solution, normal saline washout, or standard care.
Do catheter washouts extend patency time in long-term indwelling urethral catheters? A randomized controlled trial of acidic washout solution, normal saline washout, or standard care.
AB PURPOSE
Blockage of long-term indwelling catheters with mineral deposit is an ongoing management issue, but evidence on optimal management is lacking. Our purpose was to examine whether catheter washouts prevent or reduce catheter blockage.
DESIGN
A multisite randomized controlled trial.
SUBJECTS AND SETTING
Adults with long-term indwelling catheters that required changing every 3 weeks or less, living in the community, and requiring supportive or continuing care were recruited. Participants were randomly assigned to 1 of 3 groups: control (usual care, no washout), saline washout, or commercially available acidic washout solution (Contisol Maelor Pharmaceuticals Ltd, Wrexham, UK).
METHODS
At baseline visit, the catheter was changed and participants were followed weekly for 8 weeks, with checks for catheter patency and urine pH. Participants randomized to saline or commercial solution had a weekly washout with the appropriate solution. Endpoints were 8 weeks (completion data), 3 or more catheter changes in the 8-week period, or symptomatic urinary tract infection (UTI) requiring antibiotics. The study hypothesis was that catheter life would be extended by 25% in the commercial solution group. It was not possible to blind participants or research nurses to washout versus no intervention, but participants in the saline and washout solution groups were blinded to solution type.
RESULTS
One hundred twelve potential participants were screened; 73 were enrolled, randomized, and included in the final analysis. Of these, 53 completed the full 8 weeks of data collection; 16 terminated early because of 3 catheter changes or self-reported 'UTI'. Other reasons for termination were hematuria, latex sensitivity, deceased/severe illness, or personal choice. Analysis of variance was used to analyze mean differences on demographic variables and mean number of weeks in study. Kaplan-Meier survival curve analysis showed no statistical difference between the groups in time to first catheter change.
CONCLUSION
At this time, the evidence is insufficient to state whether catheter washout with saline or Contisol is more effective than usual care with no washout in preventing blocking. No increased risk of UTI was associated with washout regimes
1528-3976
82-90
Moore, Katherine N.
0f0c315d-93bd-4231-8ad1-aa11ac9dbf10
Hunter, Kathleen F.
0eaa89d3-108a-450c-9b3a-20b14b1f4c74
McGinnis, Rosemary
748de2a2-b186-44b6-abf8-bbceda54105d
Bacsu, Chasta
89b740da-5829-40fc-8d36-4db74cb2ffde
Fader, Mandy
c318f942-2ddb-462a-9183-8b678faf7277
Gray, Mikel
f83f2132-18e5-4f16-b925-874730430fb0
Getliffe, Kathy
309763e4-e8cb-4956-9cde-b37886d6b8bd
Chobanuk, Janice
ec561852-b9ee-4ef7-b0f7-fc52853435ec
Puttagunta, Lakshmi
f7f285b3-f6a2-4d7b-86d6-827ade3c8247
Voaklander, Donald C.
347d1687-32a9-4aeb-8a23-4ce952e1c8f9
Moore, Katherine N.
0f0c315d-93bd-4231-8ad1-aa11ac9dbf10
Hunter, Kathleen F.
0eaa89d3-108a-450c-9b3a-20b14b1f4c74
McGinnis, Rosemary
748de2a2-b186-44b6-abf8-bbceda54105d
Bacsu, Chasta
89b740da-5829-40fc-8d36-4db74cb2ffde
Fader, Mandy
c318f942-2ddb-462a-9183-8b678faf7277
Gray, Mikel
f83f2132-18e5-4f16-b925-874730430fb0
Getliffe, Kathy
309763e4-e8cb-4956-9cde-b37886d6b8bd
Chobanuk, Janice
ec561852-b9ee-4ef7-b0f7-fc52853435ec
Puttagunta, Lakshmi
f7f285b3-f6a2-4d7b-86d6-827ade3c8247
Voaklander, Donald C.
347d1687-32a9-4aeb-8a23-4ce952e1c8f9

Moore, Katherine N., Hunter, Kathleen F., McGinnis, Rosemary, Bacsu, Chasta, Fader, Mandy, Gray, Mikel, Getliffe, Kathy, Chobanuk, Janice, Puttagunta, Lakshmi and Voaklander, Donald C. (2009) Do catheter washouts extend patency time in long-term indwelling urethral catheters? A randomized controlled trial of acidic washout solution, normal saline washout, or standard care. Journal of Wound, Ostomy and Continence Nursing, 36 (1), 82-90. (doi:10.1097/01.WON.0000345181.37656.de).

Record type: Article

Abstract

AB PURPOSE
Blockage of long-term indwelling catheters with mineral deposit is an ongoing management issue, but evidence on optimal management is lacking. Our purpose was to examine whether catheter washouts prevent or reduce catheter blockage.
DESIGN
A multisite randomized controlled trial.
SUBJECTS AND SETTING
Adults with long-term indwelling catheters that required changing every 3 weeks or less, living in the community, and requiring supportive or continuing care were recruited. Participants were randomly assigned to 1 of 3 groups: control (usual care, no washout), saline washout, or commercially available acidic washout solution (Contisol Maelor Pharmaceuticals Ltd, Wrexham, UK).
METHODS
At baseline visit, the catheter was changed and participants were followed weekly for 8 weeks, with checks for catheter patency and urine pH. Participants randomized to saline or commercial solution had a weekly washout with the appropriate solution. Endpoints were 8 weeks (completion data), 3 or more catheter changes in the 8-week period, or symptomatic urinary tract infection (UTI) requiring antibiotics. The study hypothesis was that catheter life would be extended by 25% in the commercial solution group. It was not possible to blind participants or research nurses to washout versus no intervention, but participants in the saline and washout solution groups were blinded to solution type.
RESULTS
One hundred twelve potential participants were screened; 73 were enrolled, randomized, and included in the final analysis. Of these, 53 completed the full 8 weeks of data collection; 16 terminated early because of 3 catheter changes or self-reported 'UTI'. Other reasons for termination were hematuria, latex sensitivity, deceased/severe illness, or personal choice. Analysis of variance was used to analyze mean differences on demographic variables and mean number of weeks in study. Kaplan-Meier survival curve analysis showed no statistical difference between the groups in time to first catheter change.
CONCLUSION
At this time, the evidence is insufficient to state whether catheter washout with saline or Contisol is more effective than usual care with no washout in preventing blocking. No increased risk of UTI was associated with washout regimes

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Published date: January 2009
Organisations: Health Sciences

Identifiers

Local EPrints ID: 72997
URI: http://eprints.soton.ac.uk/id/eprint/72997
ISSN: 1528-3976
PURE UUID: 3fe72875-895c-4e79-ab2a-eeb59c16691d

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Date deposited: 25 Feb 2010
Last modified: 19 Jul 2019 23:42

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Contributors

Author: Katherine N. Moore
Author: Kathleen F. Hunter
Author: Rosemary McGinnis
Author: Chasta Bacsu
Author: Mandy Fader
Author: Mikel Gray
Author: Kathy Getliffe
Author: Janice Chobanuk
Author: Lakshmi Puttagunta
Author: Donald C. Voaklander

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