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BD^® MaxPlus™ and BD^® MaxZero™ Needle‑free Connector and Extension Sets

Demonstrated in 10 peer-reviewed published studies to reduce catheter-related complications^1–10

MaxPlus™ and MaxZero™ Needle-free Connector

Ready to learn more? Let’s have a conversation.

Overview
Results and Clinical Studies
Products & Accessories
EIFU & Resources

The MaxPlus™ and MaxZero™ Needle-free Connector technology is designed to help reduce the risk of infections and occlusions.⁷

The differentiated MaxPlus™ and MaxZero™ Needle-free Connector technology has been helping facilities reduce central line-associated bloodstream infections (CLABSIs) and occlusions for over 10 years^1–10

lower risk of CLABSI¹

The MaxPlus™ Needle-free Connector was shown to reduce the risk of CLABSI by 63%, compared to other needle-free connectors, in a 2014 meta-analysis published in the American Journal of Infection Control¹

reduction in occlusions²

In a retrospective observational study of 720 home infusion patients, the MaxZero™ Needle-free Connector reduced PICC^{^} occlusion rates by 55.1% (p=0.001), compared to a leading neutral displacement connector²

^{^} PICC: Peripherally Inserted Central Catheter.

The MaxPlus™ Needle-free Connector has an FDA-cleared label statement demonstrating a reduction in CLABSIs¹¹

2013 CMS Hospital Compare data reported by 3,075 U.S. hospitals, accounting for nearly 11,000 CLABSIs associated with nearly 10 million catheter days, show that hospitals using the MaxPlus™ Needle-free Connector had lower unadjusted CLABSI rates, as well as lower standardised infection ratios, compared to hospitals not using the MaxPlus™ Needle-free Connector.^1,3

Not all connectors are created equal

Explore the design innovations that differentiate MaxPlus™ and MaxZero™ Needle-free Connector technology—and how they can help you reduce catheter-related complications, compared to other needle-free connector designs

The needle-free connector you choose impacts the rate of catheter-related complications in your facility.^16,17 Refer to our clinical evidence compendium for real-world evidence of helping facilities reduce catheter-related complications.^1-10 Explore the design innovations that differentiate MaxPlus™ and MaxZero™ Needle-free Connector technology—and how they can help you reduce catheter-related complications, compared to other needle-free connector designs.

Our powerful evidence-based assessments, with analytics and benchmarks, are the first phase of BD Vascular Access Management—and the first step on the path to help you reduce complications and improve patient care.

Learn more

* Compared to the standard of care that included a standard peripheral catheter and three way stopcock among other elements.

Tabak YP, Jarvis WR, Sun X, Crosby CT, Johannes RS. Meta-analysis on central line-associated bloodstream infections associated with a needleless intravenous connector with a new engineering design. Am J Infect Control. 2014;42(12):1278–1284. doi: 10.1016/j.ajic.2014.08.018.
Williams A. Catheter occlusion in home infusion: the influence of needleless connector design on central catheter occlusion. J Infus Nurs. 2018;41(1):52–57. doi: 10.1097/NAN.0000000000000259.
Tabak YP, Johannes RS, Sun X, Crosby CT, Jarvis WR. Innovative use of existing public and private data sources for postmarketing surveillance of central line-associated bloodstream infections associated with intravenous needleless connectors. J Infus Nurs. 2016;39(5):328–335. doi: 10.1097/NAN.0000000000000185.
Costello JM, Morrow DF, Graham DA, Potter-Bynoe G, Sandora TJ, Laussen PC. Systematic intervention to reduce central line-associated bloodstream infection rates in a pediatric cardiac intensive care unit. Pediatrics. 2008;121(5):915–923. doi: 10.1542/peds.2007-1577.
Wallace MC, Macy DL. Reduction of central line-associated bloodstream infection rates in patients in the adult intensive care unit. J Infus Nurs. 2016;39(1):47–55. doi: 10.1097/NAN.0000000000000151.
Sandora TJ, Graham DA, Conway M, Dodson B, Potter-Bynoe G, Margossian SP. Impact of needleless connector change frequency on central line-associated bloodstream infection rate. Am J Infect Control. 2014;42(5):485–489. doi: 10.1016/j.ajic.2014.01.022.
Royer T. Implementing a better bundle to achieve and sustain a zero central line-associated bloodstream infection rate. J Infus Nurs. 2010;33(6):398–406. doi: 10.1097/NAN.0b013e3181f8586b.
Casey AL, Karpanen TJ, Nightingale P, Chaganti S, Elliott TSJ. Microbiologic contamination of a positive- and a neutral-displacement needleless intravenous access device in clinical use. Am J Infect Control. 2016;44(12):1678–1680. doi: 10.1016/j.ajic.206.06.027.
Clavier T, Ferguen M, Gouin P, et al. Impact of BD MaxZero™ needle-free connector on the incidence of central venous catheter-related infections in surgical intensive care unit. Aust Crit Care. 2019;32(2):107–111. doi: 10.1016/j.aucc.2018.03.003.
Hankins R, Majorant OD, Rupp ME, et al. Microbial colonization of intravascular catheter connectors in hospitalized patients. Am J Infect Control. 2019;47(12):1489–1492. doi: 10.1016/j.ajic.2019.05.024.
BD MaxPlus™ Needle-free Connector Directions for Use. 630-00658; 2015.
Gorski LA, Hadaway L, Hagle ME, et al. Infusion Therapy Standards of Practice, 8th Edition. J Infus Nurs. 2021;44(1S,1):S1–S224. doi: 10.1097/NAN.0000000000000396.
International Nosocomial Infection Control Consortium (INICC) Care bundles to prevent central and peripheral line-related bloodstream infections. INICC website. http://www.inicc.org/media/docs/2017-INICCBSIPreventionGuidelines.pdf. Published January 1, 2017. Accessed June 2, 2021.
González López J, Arribi Vilela A, Fernández Del Palacio E, et al. Indwell times, complications and costs of open vs closed safety peripheral intravenous catheters: a randomized study. J Hosp Infect. 2014;86(2):117–126. doi: 10.1016/j.jhin.2013.10.008.
Bausone-Gazda D, Lefaiver CA, Walters SA. A randomized controlled trial to compare the complications of 2 peripheral intravenous catheter-stabilization systems. J Infus Nurs. 2010;33(6):371–384.doi: 10.1097/NAN.0b013e3181f85be2.
Hadaway L. Needleless connectors for IV catheters. Am J Nurs. 2012;112(11):32–44. doi: 10.1097/01.NAJ.0000422253.72836.c1.
Curran E. Needleless connectors: the vascular access catheter’s microbial gatekeeper. J Infect Prev. 2016;17(5):234–240. doi: 10.1177/1757177416657164.
Guenezan J, Marjanovic N, Drugeon B, et al. Chlorhexidine plus alcohol versus povidone iodine plus alcohol, combined or not with innovative devices, for prevention of short-term peripheral venous catheter infection and failure (CLEAN 3 study): an investigator-initiated, open-label, single centre, randomised-controlled, two-by-two factorial trial. Lancet Infect Dis. 2021. doi: 10.1016/S1473-3099(20)30738-6.
Lange VR. Use of different designed needle-free connectors: a snapshot of central venous catheter
intraluminal blood occlusion and central line-associated bloodstream infection in hospitals. International Journal of Infection Control. 2024(20). doi.org/10.3395/ijiic.v20.23731

A 2024 study by Dr. Victor Lange published in International Journal of Infection Control found that the use of MaxPlus™ and MaxZero™ correlated with lower rates of both CLABSI and intraluminal catheter blood occulation, which are known risk factors for infections.¹⁹

Evaluate published outcomes of infection risks associated with each type of needleless connector

when making product purchase decisions, focusing on risks, benefits and educational requirements.

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Infusion Nurses Society (INS) 2024 Infusion Therapy Standards of Practice¹²

Use needleless connectors (NC) as Intravascular (IV) connection devices.

Use a luer-lock mechanism to ensure a secure junction when attaching NC to a Vascular Access Device (VAD) or access site. Avoid three-way stopcocks as IV connection devices.

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International Nosocomial Infection Control Consortium (INICC) 2017 Care Bundles to Prevent Central and Peripheral Line-Related Bloodstream Infections¹³

Explore the results and clinical studies below to learn more about the evidence supporting MaxPlus™ and MaxZero™ Needle-free Connector technology

Meta-analysis

The MaxPlus™ Needle-free Connector was shown to reduce the risk of CLABSI by 63%, compared to other needle-free connectors, in a 2014 peer-reviewed meta-analysis reporting on 7 studies, published in the American Journal of Infection Control,¹ and is associated with lower CLABSI risk, independent of seasonality, case mix index, infusion care and cleaning practices.¹

Systematic review

A systematic review of 2013 CMS Hospital Compare data from 3,074 hospitals, accounting for nearly 11,000 CLABSIs associated with nearly 10 million catheter days, shows that hospitals using the MaxPlus™ Needle-free Connector had lower unadjusted CLABSI rates, as well as lower standardised infection ratios, compared to hospitals not using the MaxPlus™ Needle-free Connector.¹

Retrospective/Prospective Occlusion Study

In a retrospective observational study of 720 home infusion patients, the BD MaxZero™ Needle-free Connector reduced PICC occlusion rates by 55.1% (p=0.001), compared to a leading neutral displacement connector.² There was a 55.1% reduction in the total number of nurse visits per 100 central line-days and a 56.4% reduction in Alteplase use and associated cost, after patients were switched to the BD MaxZero™ Needle-free Connectors.²

Retrospective/Prospective CLABSI Studies

A multidisciplinary evidence-based initiative consisting of a CVL insertion, access and maintenance bundle, including implementation of the BD MaxPlus™ Needle-free Connector, resulted in a reduction in CLABSIs from an estimated 7.8 CLABSIs per 1000 catheter days to 2.3 CLABSIs per 1000 catheter days.⁴

Retrospective/Prospective CLABSI Studies

An ICU in a suburban Baltimore hospital reduced CLABSI rates to zero in 2012, by revising its Central Vascular Access Device (CVAD) Policy policies and initiatives and implementing a bundled approach, including the use of MaxPlus™ Needle-free Connectors.⁵