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BD PosiFlush™ 4% sodium citrate pre-filled lock syringe

Maximize catheter patency and minimize risk of adverse events with BD PosiFlush™ 4% sodium citrate pre-filled lock syringes.

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Maintaining catheter patency and preventing catheter-related bloodstream infections (CRBSIs) are central goals in vascular access management. BD PosiFlush™ pre-filled syringes are uniquely designed to standardize and enhance best clinical practice for improved patient outcomes and greater clinical efficiency. With a full range of flushing and locking solutions, including a new 4% sodium citrate lock solution, BD PosiFlush™ pre-filled syringes provide clinicians with the right tools to meet their clinical needs. Recommended by clinical practice guidelines as an alternative to heparin,1 4% sodium citrate provides equivalent catheter patency while offering an improved safety profile, reduction in the risk of CRBSIs and prevention of biofilm formation—all at a lower cost13

Features and Benefits

Maximize catheter patency, minimize risk*

4% sodium citrate lock solution reduced the number of hemodialysis catheters exchanged per 1,000 days by 59% vs heparin 5,000 U/mL (1.33 vs 3.24, p = 0.002).1

Fewer CRBSIs vs heparin 5,000 U/mL*

45% fewer catheter-related bloodstream infections (CRBSIs) (11 vs 20; p = 0.026) and 57% fewer CRBSIs/1,000 catheter-days (0.81 vs 1.90; p = 0.026).1

Supported by guidelines

Recommended by several international guidelines, including INS 20162, CVAA 20133, CANNT4, ASDIN 20085 and ERBP 2007.6

Fewer bleeding events vs heparin 5,000 U/mL*

67% reduction in systemic bleeding events (7 vs 21; p = 0.035) with no risk of heparin-induced thrombocytopenia.6

Equivalent anticoagulation and maintenance of catheter patency 1,7–10*

Similar antithrombotic efficacy and maintenance of catheter function vs heparin 5,000–10,000 U/mL.

Equivalent patency without heparin-related adverse events 1,7–10*

Not associated with systemic anticoagulation, bleeding risks or heparin-induced thrombocytopenia (HIT).

Associated with significantly fewer CRBSIs 1,7–10*

Significantly fewer CRBSI with 4% sodium citrate vs 5,000 U/mL heparin  (0.81 vs 1.90/1,000 catheter-days, p = 0.026).

May help prevent biofilm formation 11,12*

Efficiently inhibits biofilm formation and cell growth of  S. aureus and S. epidermidis.

Improve CVC dwell time 1,7–10*

Time from catheter insertion to CVC exchange was significantly improved  (p = 0.04).

May be more cost-effective than heparin locks in vials 7,9*

Up to 85% reduction in the costs associated with catheter-locking vs. heparin. 8

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* Current data only validated in hemodialysis catheters.

  1. Yon CK, Low CL. Sodium citrate 4% versus heparin as a lock solution in hemodialysis patients with central venous catheters. Am J Health Sys Pharm. 2013;70(2):131-136.
  2. Gorski LA, Hadaway L, Hagle ME, McGoldrick M, Orr M, Doellman D. Infusion therapy standards of practice. J Infus Nurs. 2016;39(Suppl 1):S1-S159.
  3. Hill J, Broadhurst D, Miller K, et al. Occlusion management guideline for central venous access devices (CVADs). Vascular Access. 2013;7(Suppl 1):1-34. 4.
  4. Canadian Association of Nephrology Nurses and Technologists. Nursing recommendations for the management of vascular access in adult hemodialysis patients: 2015 update. CANNT J. 2015;25( Suppl 1):1-48.
  5. Moran JE, Ash SR, ASDIN Clinical Practice Committee. Locking solutions for hemodialysis catheters; heparin and citrate—a position paper by ASDIN. Semin Dial. 2008;21(5):490-492.
  6. MacRae JM, Dojcinovic I, Djurdjev O, et al. Citrate 4% versus heparin and the reduction of thrombosis study (CHARTS). Clin J Am Soc Nephrol. 2008;3(2):369-374.
  7. Grudzinski L, Quinan P, Kwok S, Pierratos A. Sodium citrate 4% locking solution for central venous dialysis catheters—an effective, more cost-efficient alternative to heparin. Nephrol Dial Transplant. 2007;22(2):471-476.
  8. Grudzinski A, Agarwal A, Bhatnagar N, Nesrallah G. Benefits and harms of citrate locking solutions for hemodialysis catheters: a systematic review and meta-analysis. Can J Kidney Health Dis. 2015;13(2)1-12.
  9. Lok CE, Appleton D, Bhola C, Khoo B, Richardson RMA. Trisodium citrate 4% - An alternative to heparin capping of haemodialysis catheters. Nephrol Dial Transplant. 2007;22(2):477-483.
  10. Tordoir J, Canaud B, Haage P, et al. EBPG on vascular access. Nephrol Dial Transplant. 2007;22(Suppl 2):ii88-ii117.
  11. Jones SM, Ravani P, Hemmelgarn BR, Muruve D, MacRae JM. Morphometric and biological characterization of biofilm in tunneled hemodialysis catheters. Am J Kidney Dis. 2011;57(3):449-455.
  12. Shanks RMQ, Sargent JL, Martinez RM, Graber ML, O’Toole GA. Catheter lock solutions influence staphylococcal biofilm formation on abiotic surfaces. Nephrol Dial Transplant. 2006;21(8):2247-2255.
  13. Gorski LA, Hadaway L, Hagle ME, McGoldrick M, Orr M, Doellman D. Infusion therapy standards of practice. J Infus Nurs. 2016;39(Suppl 1):S1–S159.