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Caps for occlusion prevention

 My hospital currently uses the MaxPlus Clear cap by Maximus.  My IV nurses are telling me that this cap leaks around the threads. This would certainly explain an increase in occlusions which we have seen. I am wondering what cap others are using that has helped decrease occlusion rates. Also, any suggestions for reducing occlusions.  I would appreciate your input.     Thanks, Kathy

There is no published data on

There is no published data on one brand of needleless connector being better or worse than another for lumen occlusion. The study I have listed below is the most recent, and has the largest patient population and is randomized. There were more than 200 peds oncology patients, more than 75,000 catheters days. Group 1 had a solid catheter cap and was flushed twice weekly with saline and heparin. Group 2 had a positive displacement mechanical valve that was flushed and locked with saline only once weekly. Group 2 had twice the amount of bloodstream infection and thrombosis.

1.    Cesaro S, Tridello G, Cavaliere M, et al. Prospective, randomized trial of two different modalities of flushing central venous catheters in pediatric patients with cancer. J Clin Oncol. Apr 20 2009;27(12):2059-2065.

The flushing and locking techniques MUST be aligned with how the needleless connector functions to have the best outcomes. I do not believe we can rely on technology alone. The technique must also be correct. If you have fluids leaking from around the needleless connector, this says you have significant problems above the usual concerns of appropriate technique though. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861


I use the CSU100 Ultrasite Valve,  made by Braun Medical Inc., for my son's duel lumen central line.  I have had no problems with leaking or occlusion.  

maxplus connectors.


We have been using the MaxPlus clear connector for about a year now and have found that our occlusion rates for our PICC's has drastically been reduced. Our Cathflo usage has decreased by at least half since we switched and did an extensive rollout on catheter care and maintenance. Our IV team is constantly around  for" re-education on the fly" I think because the caps are clear, the nurses are very concientious about making sure that cap has no bloody residual present. We also changed our policy and do a cap change with every blood draw. Also since we switched our infection rates have been ZERO for the last year! By the way we have never had a problem with leakage around the threads.

                                                                  Cherylanne Perry RN,CRNI

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