Effect of Fluids on Life Span of Peripheral Arterial Lines

Abstract

This study examines the effect of two different fluids to maintain peripheral arterial line patency at 1 to 2 ml/hr in a randomized controlled trial. Sixty sick newborn infants requiring ventilatory support and frequent blood gas monitoring were randomly assigned to receive either heparinized normal saline (HNS) or heparinized 5% dextrose water (HD5W) to maintain peripheral arterial line patency. One unit of heparin was added to each mililiter of both solutions. The duration of functional arterial lines, sodium balance, and number of peripheral punctures for blood glucose monitoring were compared using Student's t test for independent samples. HNS peripheral arterial catheters functioned significantly longer than HD5W without increased risk of hypernatremia. We conclude that HNS in arterial catheters is safe, lasts longer, and saves the infant (1500 gm or more) from the unnecessary stress of multiple peripheral punctures for blood glucose measurements, which can be obtained from the arterial catheter if glucose is not part of the infusate.

Thromboembolic Disease and Antithrombotic Therapy in Newborns

“…57 In a randomized controlled trial, Rais-Bahrami et al evaluated premature catheter removal in 60 newborns with peripheral arterial catheters. 58 Patency of peripheral arterial catheters was prolonged in infants receiving UFH normal saline flushes compared to UFH dextrose flushes. 58 Butt et al assessed a flow rate of 2 mL/hour and 1 mL/hour in 319 newborns and children and reported that there was no significant difference for duration of catheter patency.…”

“…58 Patency of peripheral arterial catheters was prolonged in infants receiving UFH normal saline flushes compared to UFH dextrose flushes. 58 Butt et al assessed a flow rate of 2 mL/hour and 1 mL/hour in 319 newborns and children and reported that there was no significant difference for duration of catheter patency. 59 However, increasing the concentration of UFH from 1 to 5 units/mL (n = 154) significantly prolonged catheter patency.…”

“…54 Peripheral lines: Three studies show that UFH prolongs the patency of peripheral lines. [57][58][59] Sellden et al assessed intermittent vs continuous flushing with UFH containing solutions in 338 infants less than 1 year of age with radial arterial catheters. 57 Catheters were removed due to malfunction in 76% of patients receiving intermittent flushes compared to 52% of patients receiving continuous infusions of UFH.…”

Antithrombotic Therapy in Neonates and Children

“…[323][324][325][326] Studies in pediatric intensive care have not separated children from neonates. Catheter patency was significantly prolonged for UFH concentration of 5 units/mL compared with 1 unit/mL, 323 UFH with normal saline vs dextrose fl ushes, 324 and papaverine-supplemented compared with placebo-supplemented solutions 326 ( Table 7 ). Recommendation 2.11.…”

Empfehlung zur Prävention nosokomialer Infektionen bei neonatologischen Intensivpflegepatienten mit einem Geburtsgewicht unter 1500 g

“…Die Zugabe von 0,25-1 U/ ml Heparin führt zu einer verlängerten Nutzungsdauer auch bei Kindern und neonatalen Patienten [331,332,333]. Eine Metaanalyse von Randolph et al kommt deshalb zu der allgemeinen Empfehlung, der arteriellen Spüllösung Heparin zuzusetzen [334].…”