A Randomized Trial of Heparin and Saline for Maintaining Intravenous Locks in Neonates

Abstract

purpose. To determine, the effects of saline, heparin 2 units (U) per ml saline, and heparin 10 U/ml saline flush solutions on the duration of intravenous (IV) locks and the incidence of IV infiltration in neonates. design. Randomized double‐blind experiment. setting. Tertiary‐care nursery. participants. Neonates (N = 90) hospitalized at birth in the intensive, intermediate care, or newborn units. main outcome measures. Total hours from the time the IV was inserted to the time the IV was removed; hours from the time the IV was first flushed to the time the IV was removed; number of IVs removed because of infiltration. results. No statistical or clinical differences between the three groups for duration of IV nor for incidence of complications. conclusions. The use of heparin in IV lock flush solution did not affect the duration of IV locks nor the incidence of infiltration in neonates.

Necessity of heparin for maintaining peripheral venous catheters: A systematic review and meta-analysis

“…In some countries and medical facilities, flushing and locking catheters with heparin solutions are becoming standard procedures. However, a number of clinical trials studying heparin in catheter maintenance failed to find significance of its efficacy (8,9,14,23,26). Therefore, several systematic reviews and meta-analyses are conducted but their results remain controversial (3,4,11).…”

“…The study populations included pediatric patients (14,15,21-24, 26-29,32,33,37-39,44), healthy volunteers and adults (7)(8)(9)16,17,20,30,31,(34)(35)(36)(40)(41)(42)(43), and the administered treatments in all studies primarily consisted of antibiotics and parenteral nutrition. Furthermore, the origin of countries reported included the USA (7,8,14,20,(26)(27)(28)30,32,33,35,43), the UK (39,40), Germany (38), France (36), the Netherlands (22), Australia (44), Italy (17), Canada (25), Ireland (34), India (15,31) and China (16). In the infusion studies, the concentration of heparin varied between 0.1 and 2 U/ml, whereas in the intermittent flush studies the concentration used varied between 2 and 100 U/ml.…”

Effectiveness of heparin solution versus normal saline in maintaining patency of intravenous locks in neonates: a double blind randomized controlled study

“…Results of these studies, analysing a peripheral IVL patency flushed with heparin versus saline in only neonates are conflicting. Several studies showed no differences between heparin (with concentrations of 1-10 units/mL) versus saline on the longevity of a peripheral IVL (Kotter 1996, Paisley et al 1997, Heilskov et al 1998, Hanrahan et al 2000, Mok et al 2007. Other studies suggested that heparin solution is more effective in maintaining patency than saline (Mudge et al 1998, Schultz et al 2002.…”

Flushing of intravenous locks in neonates: no evidence that heparin improves patency compared with saline

“…An additional aim was to examine potential other variables that may contribute to successful maintenance of intravenous locks. The study adds to a small body of research on the subject, which was of varying design and yielded conflicting results 1–3…”