A British Columbia-led clinical research team has conducted a study that may significantly enhance care for critically ill patients in intensive care units around the globe. Researchers from Royal Columbian Hospital and Simon Fraser University have published their findings in the Journal of the American Medical Association (JAMA), a leading peer-reviewed medical journal.
Study Overview and Key Findings
The study, named the CLiCK trial, focused on central venous access devices, commonly referred to as central lines, in adult ICU patients. The results were presented by senior author Dr. Steven Reynolds at the American Thoracic Society International Conference on May 18. Central lines are catheters used to deliver fluids, medications, antibiotics, and nutrition to most critical care patients. While essential, they carry risks of infection and clotting that can impede functionality.
The multi-centre clinical trial involved 1,468 adult ICU patients across six Canadian hospitals: Royal Columbian Hospital, Surrey Memorial Hospital, Royal Jubilee Hospital, Nanaimo Regional General Hospital, St. Boniface Hospital, and Burnaby Hospital. It was designed as a triple-blind, cluster-randomized crossover trial to compare usual care with a 4% tetrasodium ethylenediaminetetraacetic acid (t-EDTA) locking solution. The solution is placed inside unused line channels to keep them open, and the trial found a significant reduction in a composite measure of complications, including catheter occlusions that required alteplase treatment.
Implications for Global ICU Care
Dr. Steven Reynolds, Critical Care Physician at Royal Columbian Hospital and Associate Professor at Simon Fraser University, emphasized the practical nature of the study. “This study tested a very practical question in ICU care: can we do more to keep central lines working safely for critically ill patients?” he said. “Because these lines are used in ICUs around the world, evidence on how to reduce complications can matter beyond one hospital or one health system. The trial found a significantly lower rate in a clinically relevant composite outcome, driven most clearly by fewer catheter occlusions requiring alteplase. It gives clinicians and health systems around the world evidence to consider, while also pointing to questions that need further study.”
The first author of the study is Marlena Ornowska, whose work on this research was part of her PhD thesis at Simon Fraser University’s Department of Biomedical Physiology and Kinesiology. She also holds a Research Associate position with the Advancing Innovation in Medicine Institute (AIM). Her doctoral work was central to the trial’s design, coordination, and manuscript development.
This study offers promising evidence for safer central line management, potentially reducing complications and improving outcomes for critically ill patients worldwide.
