Limited evidence showed that there was no difference between valved and non-valved PICCs in the incidence of occlusion of the catheters or PICC-related blood stream infection and complications (obstruction, rupture). Meta-analysis from data from 10 RCTs showed that, in general, heparin saline and normal saline had similar efficacy in maintaining the patency of CVCs, but patency with heparin use is statistically better than normal saline when placement was 30 days or less. Differences between heparin and saline use in secondary outcomes such as heparin-induced thrombocytopenia, hemorrhage, central venous thrombosis and catheter-related bloodstream infection were not statistically significant. The findings from this review are in agreement with previous CADTH reports which also found no difference in terms of frequency of occlusion in patients who had a valved versus a non-valved PICCs, and similar patency between heparin and saline use for CVCs, though the previous report did not have information specific to the <30 day subgroup.^3,4