38772
document
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 . 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 .
38773
Intervention_Physical
catheter washouts
38774
Intervention_Pharmacological
acidic washout solution , normal saline washout
38775
Intervention_Control
standard care .
38776
Intervention_Physical
catheter washouts
38777
Intervention_Control
control ( usual care , no washout
38778
Intervention_Educational
) ,
38779
Intervention_Physical
saline washout
38780
Intervention_Educational
, or
38781
Intervention_Physical
commercially available acidic washout solution ( Contisol
38782
Intervention_Pharmacological
saline or commercial solution
38783
Intervention_Physical
washout
38784
Intervention_Pharmacological
commercial solution
38785
Intervention_Pharmacological
washout versus
38786
Intervention_Control
no intervention
38787
Intervention_Pharmacological
saline and washout solution
38788
Intervention_Pharmacological
saline
38789
Intervention_Pharmacological
Contisol
38790
Intervention_Physical
usual care with no washout
38791
Intervention_Pharmacological
washout regimes .
38792
Outcome_Other
patency time
38793
Outcome_Other
long-term indwelling
38794
Outcome_Physical
catheter blockage
38795
Outcome_Physical
checks for catheter patency
38796
Outcome_Physical
urine pH
38797
Outcome_Physical
symptomatic urinary tract infection ( UTI )
38798
Outcome_Other
termination
38799
Outcome_Physical
hematuria
38800
Outcome_Adverse-effects
, latex sensitivity , deceased/severe illness
38801
Outcome_Other
personal choice
38802
Outcome_Other
time to first catheter change
38803
Outcome_Physical
risk of UTI
38804
Participant_Age
One hundred twelve potential participants were screened ; 73 were enrolled , randomized , and included