A Better Lock for Central Lines in the ICU?

Central venous access devices (CVADs) are a routine part of ICU care but pose notable risks, including central line–associated bloodstream infections (CLABSIs) and occlusions requiring thrombolytic treatment or line removal. Smaller studies have suggested that locking lines with 4% tetrasodium EDTA can help prevent these complications. To test this approach further, researchers conducted an industry-sponsored, pragmatic randomized trial involving nearly 1500 ICU patients across six Canadian hospitals.

All patients had a CVAD in place with at least one unused lumen that was subsequently locked with EDTA or a control solution (saline for most catheter types). The primary outcome was a composite of CLABSI, occlusion requiring alteplase, …