Heparin Saline Versus Normal Saline for Flushing and Locking Peripheral Venous Catheters in Decompensated Liver Cirrhosis Patients

Wang, Rui; Zhang, Mingguang; Luo, Ou; Li, Jiaxin; Tang, Yun-Jing; Luo, Yanli; Zhou, Min; Tang, Li; Zhang, Zong-Xia; Wu, Hao; Chen, Xin-Zu

doi:10.1097/md.0000000000001292

Cited by 9 publications

(21 citation statements)

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“…Notwithstanding these benefits, administration of heparin may result in potential complications such as bleeding, thrombocytopenia and allergy (51)(52)(53). These drawbacks may discourage the clinical use of heparin at higher concentrations, although the morbidity of the complications has been low in previous observations (7,13,16,51,53).…”

Section: Discussionmentioning

confidence: 99%

“…Among the 32 studies included in the present review, the scale ranged from 16 patients/16 catheters to 451 patients/1,257 catheters. In total, 10 studies reported multiple catheters per patient (15)(16)(17)23,25,27,(37)(38)(39)43), with the rest of the studies reported a single catheter per patient. 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.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…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.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…Furthermore, a routine use of heparin for the most extensively placed peripheral venous catheters may unnecessarily increase the cost of health care when its cost-effectiveness remains unclear (14). As such, a number of RCTs with inconsistent or conflicting results have been published, prompting further debate on the use of heparin solution for peripheral venous catheter maintenance (15)(16)(17). Therefore, this updated systematic review and meta-analysis of RCTs was conducted to more precisely evaluate the role of heparin in maintaining peripheral venous catheters.…”

Section: Introductionmentioning

confidence: 99%

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

You

Jiang

Chen

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. Heparin has typically been used as a flushing or infusion solution for vascular lines in daily practice. However, several clinical trials have yielded controversial results about the benefits of heparin in maintaining peripheral venous catheters. The present meta-analysis was conducted to evaluate the efficacy of heparin on the patency profiles and complications in peripheral intravenous catheters. PubMed, Embase and Cochrane Central Register of Controlled Trials were searched up to February 2016 for randomized controlled trials comparing heparin with placebo in maintaining peripheral intravenous catheters. Additional studies were retrieved from the reference lists of identified articles. In total 32 eligible studies were included, from which the pooled standard mean difference (SMD), relative risk (RR) and corresponding 95% confidence interval (CI) were calculated. The use of heparin as a continuous infusion significantly prolonged the duration of patency (SMD, 0.90; 95% CI, 0.48-1.32; P<0.001), reduced rates of infusion failure (RR, 0.83; 95% CI, 0.76-0.92; P<0.001) and occlusion (RR, 0.82; 95% CI, 0.69-0.98; P<0.05) in a peripheral intravenous catheter. However, there were no significant changes in the duration of patency and infusion failure when heparin was used intermittently as a flushing solution, although a significantly decreased risk of occlusion was observed in this setting (RR, 0.80; 95% CI, 0.66-0.98; P<0.05). Furthermore, the risk of phlebitis was significantly decreased by both continuous infusion (RR, 0.66; 95% CI, P<0.01) and intermittent flushing (RR, 0.70; 95% CI, 0.56-0.86; P<0.01) of heparin in peripheral venous catheters. In conclusion, the use of heparin as continuous infusion in peripheral intravenous catheters improved the duration of patency, reduced infusion failure and phlebitis, whereas heparin as intermittent flushing showed more benefits in ameliorating phlebitis rather than in patency profiles.

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Section: Discussionmentioning

confidence: 99%

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

You

Jiang

Chen

et al. 2017

Experimental and Therapeutic Medicine

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“…Ribeirão Preto, SP, 2016 Quadro 10 -Síntese do estudo Nilsen et al, 2003. Ribeirão Preto -SP, 2016 Quadro 11 -Síntese do estudo Wang et al, 2015. Ribeirão Preto, SP, 2016 (BAIOCCO et al, 2013).…”

Section: Introductionunclassified

Solução salina versus solução de heparina na perviedade do cateter venoso periférico na terapia venosa intermitente: revisão sistemática

Ferrari¹

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DEDICATÓRIA "A DEUS, que confere ao homem toda sabedoria e conhecimento"."Dedico este trabalho a todos aqueles qυе de alguma forma estiveram е estão próximos de mim, fazendo está vida valer cada vez mais а pena". "À enfermagem, minha amada enfermagem". "É preciso se expor sem medo de dar vexame. É preciso colocar o trabalho na rua. É preciso saber ouvir um não e, depois de secar as lágrimas, seguir batalhando. Arriscar, é o nome do jogo. Muitos perdem, poucos ganham. Mas quem não tenta, não tem ao menos o direito de reclamar". Martha MedeirosAGRADECIMENTOS À minha orientadora Renata Cristina de Campos Pereira Silveira, a qual tenho o grande prazer de conhecer desde a época do TMO, quando pude conhecer toda a sua trajetória, e hoje essa grande professora que muito me apoiou no desenvolvimento deste trabalho, respeitando minhas limitações, dificuldades e oferecendo o apoio necessário. À minha amada família pelo apoio e paciência com as muitas ausências. À amiga Amanda Salles Margatho pela grandiosa colaboração para o início desta jornada. À minha irmã Rita Constantini pelo apoio no desenvolvimento deste trabalho. À amiga Vanessa Cristina Leopoldo pelo companheirismo e amizade, dividindo comigo a jornada da pós-graduação. A toda a equipe do CIREP-HCRP, em especial às amigas Tânia Becker, Adriana Nogueira e Elidia Magnani, que compartilham comigo todas as dificuldades e alegrias proporcionadas pelo desenvolvimento de nosso trabalho. A todos os colegas de mestrado que tornaram esta caminhada mais agradável e prazerosa. À amiga Eliana Lisboa, pela amizade sincera, estando presente em todos os momentos desde que enveredamos pelos caminhos da enfermagem e que, indiretamente, é responsável pelo alcance deste trabalho. A todos os professores do curso de mestrado, os quais, com suas valiosas explanações, puderam acrescentar valiosos conhecimentos para a conclusão deste trabalho. Aos funcionários da Escola de Enfermagem de Ribeirão Preto, que ofereceram suporte sempre que necessário. RESUMO CONSTANTINI-FERRARI, A. A. Solução salina versus solução de heparina na perviedade do cateter venoso periférico na terapia venosa intermitente: revisão sistemática. 2016. 70 p. Dissertação (Mestrado) -Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, 2016.O uso do cateter venoso periférico intermitente em pacientes hospitalizados pode lhes trazer grandes benefícios, proporcionando maior liberdade com a higiene pessoal, alimentação, deambulação, além melhorias para a equipe de enfermagem com redução das rotinas diárias. No entanto, obstrução do cateter é algo que vem na contramão de uma assistência adequada, causando desconforto para o paciente e aumento do trabalho de enfermagem. Para evitar tal evento e garantir a perviedade do cateter intravascular, deve-se realizar o flushing com solução salina ou solução de heparina, após a administração de medicamentos ou em horários programados de acordo com o protocolo interno das instituições de saúde. Nesse contexto, surge o questionamento de qual é a melhor soluç...

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Heparin versus 0.9% sodium chloride locking for prevention of occlusion in central venous catheters in adults

López-Briz

García

Cabello

et al. 2022

Cochrane Database of Systematic Reviews

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Heparin Saline Versus Normal Saline for Flushing and Locking Peripheral Venous Catheters in Decompensated Liver Cirrhosis Patients

Abstract: Supplemental Digital Content is available in the text

Cited by 9 publications

References 23 publications

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

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

Solução salina versus solução de heparina na perviedade do cateter venoso periférico na terapia venosa intermitente: revisão sistemática

Heparin versus 0.9% sodium chloride locking for prevention of occlusion in central venous catheters in adults

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