{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:11:54Z","timestamp":1777936314200,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T00:00:00Z","timestamp":1747872000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      Needle-free connectors (NFCs) are closure systems for vascular catheters largely used because effectively reduce needlestick incidents. They are classified based on their impact on the fluid column within the catheter as\n                      <jats:italic toggle=\"yes\">positive<\/jats:italic>\n                      (fluid displacement into the vein),\n                      <jats:italic toggle=\"yes\">negative<\/jats:italic>\n                      (fluid displacement back from the vein into the catheter),\n                      <jats:italic toggle=\"yes\">neutral<\/jats:italic>\n                      (minimal displacement), or\n                      <jats:italic toggle=\"yes\">anti-reflux<\/jats:italic>\n                      (equipped with additional anti-reflux valve). Each category has specific usage and clamping procedures. This study aimed to evaluate the backflow volume (BV) when different NFC categories and clamping sequences are used with a peripherally inserted central catheter (PICC) and a Midline catheter (MC).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      In this bench study, four types of NFCs with different flow displacement behavior were studied. Each NFC was evaluated using two different catheters: a 4\u2009Fr\u2009\u00d7\u200960\u2009cm single-lumen catheter (PICC), and a 4\u2009Fr\u2009\u00d7\u200925\u2009cm single-lumen catheter (MC). The experimental model simulated the physiological blood pressure of the superior vena cava. Three operators performed specific sealing sequences for each combination of NFC and catheter. After that, the BV (mm\n                      <jats:sup>3<\/jats:sup>\n                      ) inside the catheter for every NFC was assessed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      None of the four NFCs was able to avoid the BV into the catheter. Positive NFC showed a lower BV as compared to the other three NFCs when tested with PICC: 0.83 [0.76\u20130.95]\u2009mm\n                      <jats:sup>3<\/jats:sup>\n                      versus 1.14 [0.95\u20131.53]\u2009mm\n                      <jats:sup>3<\/jats:sup>\n                      of Q-SYTE, versus 1.27 [1.02\u20131.59]\u2009mm\n                      <jats:sup>3<\/jats:sup>\n                      of Neutron, versus 1.24 [0.95\u20131.84]\u2009mm\n                      <jats:sup>3<\/jats:sup>\n                      of Bionector, whereas no differences were observed when tested with Midline. No differences were observed between different clamping sequences when used with\n                      <jats:italic toggle=\"yes\">neutral<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">anti-reflux<\/jats:italic>\n                      NFCs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      This study examined the performance of various NFC technologies with PICC and Midline. While no device eliminates BV, positive displacement NFCs showed lower flow reflux compared to the others when used with PICC. No difference between clamping sequences was observed for\n                      <jats:italic toggle=\"yes\">neutral<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">anti-reflux<\/jats:italic>\n                      NFCs.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11297298251340469","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T05:19:45Z","timestamp":1747891185000},"page":"475-480","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluating needle-free connectors associated backflow in Midline and peripherally inserted central catheters: A top bench study"],"prefix":"10.1177","volume":"27","author":[{"given":"Daniele","family":"Privitera","sequence":"first","affiliation":[{"name":"Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Milan, Italy"},{"name":"Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5912-1822","authenticated-orcid":false,"given":"Davide","family":"Giustivi","sequence":"additional","affiliation":[{"name":"Post Anesthesia Care Unit, Vascular Access Team ASST Lodi, Lodi, Lombardy, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisa","family":"Nardin","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrico","family":"Gianfranceschi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefania","family":"Fiorini","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabetta","family":"Fiorina","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University Maggiore della Carit\u00e0 Hospital, Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Revere","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicol\u00f2","family":"Capsoni","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy"},{"name":"Department of Emergency Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,5,22]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1329-9360(16)30355-8"},{"issue":"6","key":"e_1_3_2_3_2","first-page":"373","volume":"13","author":"FDA issues safety alert for hypodermic needles on secondary i.v. administration sets","year":"1992","unstructured":"FDA issues safety alert for hypodermic needles on secondary i.v. administration sets. 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