Stop Using Paraffin Oil to Lubricate Indwelling Catheters!

Indwelling catheterization is a common clinical nursing technique, with the catheter being an essential medical device. The balloon is a vulnerable part of disposable catheters.

From January 1st to May 30th, 2019, the China National Medical Products Administration Adverse Drug Reaction Monitoring Center received 658 reports of suspected adverse events related to catheters. Among these, 318 reports involved balloon rupture during use, accounting for 48.3%.

So, what harm can balloon rupture cause to patients during indwelling catheterization? Why is the incidence of balloon rupture so high? And how should we prevent it in clinical practice?

Hazards Caused by Balloon Rupture

The main injuries from balloon rupture primarily include the need for secondary catheterization, impact on postoperative recovery, pain, urinary retention, and urethral bleeding.

In some cases, balloon fragments were left in the body, potentially even causing permanent damage to the patient's bladder function.

For some patients undergoing urethral surgery, the catheter plays a supportive role in postoperative recovery. Balloon rupture can lead to surgical failure, posing the risk of a second surgery.

What Causes Balloon Rupture?

A urinary catheter is a medical device used for urine drainage, bladder irrigation, etc. Its materials include natural latex, rubber, silicone, or polyvinyl chloride (PVC). The main types are single-lumen, double-lumen, and triple-lumen catheters, and they are widely used in clinical practice.

Investigations revealed that catheters with ruptured balloons were primarily made of latex. Relevant literature confirms that latex catheters have a significantly increased risk of balloon rupture when used with petroleum-based lubricants.

The main reason for balloon rupture in latex catheters is the use of petroleum-based lubricants contrary to the instructions for use, common clinical examples being liquid paraffin and Vaseline.

Why Do Petroleum-Based Lubricants Increase the Risk of Balloon Rupture?

In clinical practice, petroleum-based lubricants like liquid paraffin and Vaseline are widely used. While non-irritating to the human body, they are highly corrosive to catheter balloons, reducing the balloon's pressure tolerance.

Liquid paraffin, in particular, significantly affects latex, rubber, and silicone catheters, greatly increasing the risk of catheter rupture.

Precautions for Using Lubricants in Clinical Practice

In clinical work, it is essential to carefully read the product instructions before use. Select the lubricant correctly based on the structure and material of the disposable catheter. Do not rely solely on experience or use catheter lubricants incorrectly and inappropriately.

For balloons made of natural latex material, water-soluble lubricants are recommended. Avoid using petroleum-based lubricants such as liquid paraffin and Vaseline.

According to relevant studies, lidocaine gel has anesthetic properties that can reduce patient pain during intubation, improving patient compliance and comfort. Glycerol, also known as glycerin, is a commonly used water-soluble suppository base.

Lidocaine gel and glycerol are characterized by high safety, being non-irritating, and non-corrosive to catheters. Simultaneously, water-soluble lubricants are easily absorbed and excreted, making them less likely to remain in the body for extended periods.

Therefore, the use of non-irritating, water-soluble substances such as lidocaine gel and glycerol as catheter lubricants is recommended.

The Advantages of Hydrophilic Catheters

An optimal solution to prevent balloon rupture and enhance patient comfort is the use of hydrophilic-coated catheters. These catheters feature a polymer coating that, upon activation with water, transforms into an extremely smooth and slippery surface. This coating is integrated, non-migrating, and provides superior lubrication throughout the entire insertion process. More importantly, as a water-based lubricant, it is completely non-reactive with the catheter material, thereby fundamentally eliminating the risk of balloon corrosion and rupture associated with petroleum-based lubricants. Additionally, hydrophilic catheters can reduce urethral mucosal irritation and injury, lowering the incidence of long-term complications such as urethral strictures.