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

Abstract

Heparin versus 0.9% sodium chloride intermittent flushing for prevention of occlusion in central venous catheters in adults. Cochrane Database of Systematic Reviews(10), CD008462.

Heparin versus 0.9% sodium chloride intermittent flushing for the prevention of occlusion in long term central venous catheters in infants and children: A systematic review

“…In the adult population, there have been several trials (Goossens et al, 2013, Schallom et al, 2012) a systematic review (Mitchell et al, 2009), and a Cochrane Review of the use of heparin versus normal saline to prevent occlusions in CVCs (Lopez-Briz et al, 2014). As evidence from adult studies is not directly transferable to paediatrics, a systematic review focused on infants and children is required.…”

Heparin solution in the prevention of occlusions in Hickman® catheters a randomized clinical trial

“…Other studies show similar results, despite the difference in the concentration of heparin, which ranged from 10 to 5,000 IU/mL, used for blocking, over time to assess the permeability and type of the catheter. This heterogeneity is confirmed in a systematic review, which verified this variety of actions (8) . and 200 mg/mL vitamin C flush and considered occlusion without reflux as the primary outcome, concluding there is a difference between the use of heparin and ISS (p <0.04), choosing the heparin solution, more effective than ISS in maintaining the permeability of the analyzed CVC (13) .…”

“…Regarding the maintenance of venous devices in general, there is already a consensus on the use of 0.9% Isotonic Saline Solution (ISS) for flush. However, for the long-term solution of CVC blockade, there is no strong clinical evidence for the ISS recommendation on the heparin solution in reducing the incidence of occlusion (5,(7)(8)(9) .…”

“…A number of studies recommend the development of clinical trials comparing different concentrations of heparin with ISS in more homogeneous samples (7)(8)10) .…”

Port in oncology practice: 3-monthly locking with normal saline for catheter maintenance, a preliminary report

“…Also, some adverse effects are associated with heparin use, such as autoimmune-mediated heparin-induced thrombocytopenia, allergic reactions and the potential for bleeding complications following multiple, unmonitored heparin flushes (11). Also, a recent Cochrane review (12) has concluded that there is no good evidence that heparin flushing of central venous catheters is better than flushing with sterile saline solution.…”