Prevention, assessment, and treatment of central venous catheter occlusions in neonatal and young pediatric patients.

Central venous catheter occlusions disrupt delivery of needed therapies to vulnerable neonatal and young pediatric patients. Nursing practices that minimize risk of catheter occlusion include proper infusion and flushing techniques. Treatment strategies vary on the basis of the source of the occlusion. Mechanical occlusions can often be resolved by altering the patient's position, correcting catheter kinks, or adjusting clamps. Occlusions caused by precipitation can be cleared through instillation of ethanol, hydrochloric acid, or sodium bicarbonate, depending on the chemistry of the infusates. Finally, the thrombolytic agent alteplase is recommended for treatment of catheter occlusion because of thrombus formation.