Estudio comparativo del mantenimiento de la permeabilidad de los catéteres venosos centrales de tres luces

Effectiveness of heparin versus 0.9% saline solution in maintaining the permeability of central venous catheters: a systematic review

“…In short, we should mention that the consensus among various authors and our results are consistent, allowing us to draw the following conclusions: the saline solution is sufficient for maintaining patency of CVC when compared to heparinized solutions (2,(9)(10)(11)(12)(13)(14)16) ; saline solution prevents exposure to complications arising from the use of heparin -these being thrombocytopenia, bleeding (11,12,14,16) … thereby adding significance when associated with differences in the dilutions used (often by the team itself ), non-uniformity of pre-established protocols and potential errors of medication preparation (1) .…”

“…Bibliography analysis of identified reference articles also allowed the inclusion of another study, thus nine studies were considered for critical appraisal: eight RCT (2,6,9,(11)(12)(13)(14)16) and one cohort study (10) .…”

“…Although on the one hand its use has enabled therapeutic advances, it has also led to the origin of various associated risks, of which infection and catheter obstruction (1)(2)(3)(4) can be highlighted; factors contributing to an increase of hospital internalizations, morbidity and hospitalization costs (4) . For these reasons, CVC handling, maintenance and optimization is complicit to the predominant value of care, where nurses must gather a body of knowledge and skills to ensure proper handling of the CVC (5) .…”

“…We cannot help but reflect on the different focuses that are necessary in this practice of nursing: thrombocytopenia is related to the frequent use of heparin; thrombocytopenia risk exists even when the exposure is minimal; heparin is found in various concentrations and formulations, increasing the risk of error in dilution preparation; and several studies have suggested that heparin is related to medication errors (1,3) . On the other hand, some studies suggest that saline flush is cost-effective, adequate and also has the benefit of not having the adverse effects of heparin and not having several presentations nor preparation required at different concentrations (2,(9)(10)(11)(12)(13)(14) . In this context, some published studies have reported that most nurses use only saline solutions, enhancing the fact that CVC flushing practices vary widely, and are currently inconsistent (15) .…”

Heparin compared with normal saline to maintain patency of permanent double lumen hemodialysis catheters: A randomized controlled trial

“…The results of this study showed that saline solution is as effective as 100 or 500 IU of heparin for maintenance of catheter patency. [12] In another study, Kaneko and colleagues compared daily saline lavage (20 ml) to locking the catheter with saline (20 ml) plus 2 ml heparin (1000 IU) and found no difference between the two methods in catheters thrombosis. [13] In contrast, some other studies have different results.…”