Emacy of Heparin in Peripheral Venous Infusion in Neonates

Benefit and risk of heparin for maintaining peripheral venous catheters in neonates: a placebo-controlled trial

“…2,3 Others also reported a reduced incidence of phlebitis when heparin was continuously infused, 4,5 whereas we did not find a difference between the groups regarding phlebitis, infiltration, or thrombus formation. However, age of children, additional treatment (eg, infusion fluids), and catheter size differed between the studies.…”

“…Prospectively, a prolongation of catheter patency of at least 24 hours was considered clinically relevant based on the previously published studies. [2][3][4][5] The secondary objectives were the incidences of major bleedings (eg, intracranial), clinical HIT, and anti-PF4/heparin antibodies. Also, the incidences of catheter-related complications (eg, phlebitis, thrombus formation, extravasation) in neonates were compared.…”

“…1 The studies using continuous heparin infusion in neonates to prolong catheter patency enrolled either very low numbers of patients or older infants, excluded patients receiving certain antibiotics, or restricted inclusion to certain catheter sizes. [2][3][4][5] Moclair and Bates 3 compared catheter patency when 0.1 IU/mL, 0.25 IU/mL, 0.5 IU/mL, or 1 IU/mL heparin was added to continuous infusion. There was an increase in efficacy to 0.5 IU/mL, but there was no difference between 0.5 IU/mL and 1 IU/mL.…”

The effect of low-dose heparin on maintaining peripherally inserted percutaneous central venous catheters in neonates

“…11,12 In studies including newborns and patients in different age groups, heparin was shown to prolong the duration of peripheral catheter patency. [14][15][16][17] We found that average duration of the catheter use was significantly longer in heparin group (12.4±4.5 days vs 9.7±4.0 days). Similar to the results of Kamala et al 11 and Shah et al, 12 we showed that after completion of therapy, the likelihood of elective catheter removal (completed TPN therapy) was higher (53.5 vs 25.6%, P ¼ 0.001) and the incidence of catheter occlusion was lower in the heparin group (19.5 vs 45.5%, P ¼ 0.001).…”

The Use of Vasoactive Agents Via Peripheral Intravenous Access During Transport of Critically III Infants and Children

“…Published rates of IV infiltration range from 10% to 70% in neonates and 11% to 23% in pediatric patients. 16,17 Our rate of PIV line infiltration (15%) was calculated based on the period that the patient was receiving a peripheral vasoactive infusion and up to 8 hours thereafter. It is possible that this percentage would increase if patients were followed up for a longer period; likewise, it is possible that some of these patients would have developed IV infiltrates regardless of the type of medication or fluid being infused.…”