Table 1.

High risk profile for development of venous access device occlusions

Risk factor	Potential result
Use of TPN	Calcium/phosphate in TPN solution can cause precipitate to form Lipid deposits can form if solution is not used within specified time limit Use of incompatible solutions
Incompatible medications	Use of incompatible medications can result in precipitation, crystallization of drug, causing partial or complete occlusion
Comorbid patient and treatment factors  Hypercoagulable status  Some malignancies  Prior  VTE Sludge formation in catheter lumens  PICC in place while undergoing surgery  Malpositioned catheter tip  Large gauge or multi-lumen catheters  Some treatment types	Increases risk of fibrin sheath formation, mural thrombi, and catheter-related DVT
Insufficient evidence for maintenance procedures	Evidence is lacking to support specific flushing protocols demonstrated to prevent occlusions

TPN: Total parenteral nutrition, VTE: Venous thromboembolism, PICC: Peripherally inserted central catheter, DVT: Deep vein thrombosis