4% Tetrasodium EDTA to Prevent Central Venous Access Device–Associated Complications: A Randomized Clinical Trial
Primary result · Composite primary outcome (per 1000 catheter-days)Result — go to the resultRate ratio 0.68 95% CI 0.47–0.96Authors' conclusion
Compared with control locking solution, use of 4% t-EDTA locking solution for CVADs reduced the incidence of a composite outcome of CVAD-associated bloodstream infection, catheter occlusion requiring alteplase use, and catheter removal due to occlusion among adult patients in the ICU.
Study context
- Population
- Adults (>18 years) in the intensive care unit (ICU) with a CVAD and at least 1 lumen not in use, 6 Canadian hospitals1,574 eligible
- Participants
- 1,468 adults
- Comparison
- 4% tetrasodium EDTA (t-EDTA) locking fluid vs control locking fluid
- t-EDTAn = 696
- Controln = 772reference
- Primary endpoint
- Composite incidence rate of CVAD-associated bloodstream infection, catheter occlusion requiring alteplase, and/or catheter removal due to occlusion
Methodological detailspragmatic, triple-blind, multicentre, cluster-randomized crossover, ICUs crossed over after 3.5-month period and 1-month follow-up
- Pragmatic
- Triple-blind
- Multicentre
- Cluster-randomized crossover
- ICUs crossed over after 3.5-month period and 1-month follow-up
Primary result
As reported in the abstract
Composite primary outcome (per 1000 catheter-days)
Rate ratio
0.68
95% CI 0.47–0.96
P = 0.03
Events by treatment group
t-EDTA vs Control
rate ratio 0.68 (95% CI 0.47–0.96); P = 0.03
Secondary outcomes
Per 1000 catheter-days
| Outcome | t-EDTA | Control | Rate ratio (95% CI) | |
|---|---|---|---|---|
| CVAD occlusion requiring alteplase | 11.67 | 17.73 | 0.66 (0.46–0.96) | |
| 0.512Rate ratio (log scale) |
Other components of primary outcome (bloodstream infection; catheter removal due to occlusion)
- Did not significantly differ between groups
Original publication
4% Tetrasodium EDTA to Prevent Central Venous Access Device–Associated Complications: A Randomized Clinical Trial. JAMA. Published 23 June 2026. doi:10.
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