A Systematic Review of Needleless Connector Function and Occlusion Outcomes: Evidence Leading the Way.

The review included studies of high, moderate, low, and very low quality, and the authors judged the overall review to be at high risk of bias. The included studies were heterogeneous in design, connector types, flushing methods, clamping practices, patient settings, and outcomes, making direct comparison difficult. The review included gray literature and many manufacturer-sponsored studies, and the authors noted concern about bias in sponsored work. The authors assessed bias but did not incorporate it into the findings or discussion. Randomized evidence was limited and not consistent across connector categories.

An author declared funding received to PICC Excellence from Nexus Medical, Inc., and research consulting not associated with this subject matter with Access Vascular, Linear Health Sciences, Parker Laboratories, and Terumo. Another author received speaking honoraria from BD Medical and 3M and holds stock in ivWatch. The remaining author declared no conflict of interest. The review included many manufacturer-sponsored studies, and the authors state that this systematic review was sponsored and may reflect potential bias.

Do not conclude that anti-reflux connectors are proven to prevent occlusion. The review is based largely on observational, heterogeneous, low-quality, and manufacturer-sponsored studies, and the authors state that higher-quality research is needed before substantial conclusions.