Randomized clinical trial analyzing maintenance of peripheral venous catheters in an internal medicine unit: Heparin vs. saline

Abstract

Background Peripheral venous catheters (PVCs) require adequate maintenance based on heparin or saline locks in order to prevent complications. Heparin has proven effective in central venous catheters, although its use in PVCs remains controversial. Our hypothesis was that saline locks are as effective as heparin locks in preventing problems with PVCs. The objective of the present study was to compare phlebitis and catheter tip colonization rates between PVCs locked with saline and those locked with heparin in patients admitted to an internal medicine department (IMD). Methods We performed a 19-month prospective, controlled, open-label, randomized clinical study of patients with at least 1 PVC admitted to the IMD of our hospital. The patients were randomized to receive saline solution (PosiFlush ® , group A) or heparin (Fibrilin ® , group B) for daily maintenance of the PVC. Clinical and microbiological data were monitored to investigate the frequency of phlebitis, catheter tip colonization, and catheter-related bloodstream infection (C-RBSI), as well as crude mortality, days of hospital stay, and days of antimicrobial treatment. Results We assessed 339 PVCs (241 patients), of which 192 (56.6%) were locked with saline (group A) and 147 (43.4%) with heparin (group B). The main demographic characteristics of the patients were distributed equally between the 2 study groups. The median (IQR) catheter days was 5 (3-8) for both groups (p = 0.64). The frequency of phlebitis was 17.7% for group A and 13.3% for group B (p = 0.30). The frequency of colonization of PVC tips was

Prevention and Treatment of Phlebitis Secondary to the Insertion of a Peripheral Venous Catheter: A Scoping Review from a Nursing Perspective

“…High incidence of phlebitis and infection of inserted PVCs has been found in emergency areas. In these cases, it is recommended to replace the catheter within the first 48 h if aseptic technique could not be ensured [7,41].…”

Randomized experimental study to evaluate the effectiveness of the Flebitis Zero project in Navarre

“…Considerando la intervención (GI/GC) como posible variable de influencia, el análisis del resto de variables directamente relacionadas con la disminución de la incidencia de flebitis en los CVP (calibre del catéter, localización del dispositivo y tipo de antiséptico empleado, entre otros) ha presentado resultados similares a los descritos e indicados por revisiones sistemáticas con nivel óptimo de evidencia [16][17][18] .…”

“…El análisis del cuidado en el mantenimiento del CVP se centra en el tipo de salinización o sellado del mismo; se aprecia una tasa similar de flebitis con el uso de solución salina y heparina 18,19 . Las guías clínicas registran el bajo nivel de evidencia de los estudios realizados sobre las medidas preventivas para disminuir la prevalencia de complicaciones 19 .…”

Colonization and Bacteremia due to Peripheral Venous Catheters in Hospitalized Children

“…This is due to contamination of the catheter dressing caused by contact with oral discharge. Catheter-induced bacteremia is the most serious complication of venous catheter use [10]. Although the infection may be due to contamination of the injectable material, or colonization of the catheter hub, most infections are due to the secondary implantation of the patient's dermal flora microorganisms into the intradermal pathway of the catheter [6,9,11].…”

“…Although the infection may be due to contamination of the injectable material, or colonization of the catheter hub, most infections are due to the secondary implantation of the patient's dermal flora microorganisms into the intradermal pathway of the catheter [6,9,11]. Have been shown a correlation between isolated organisms in bacteremia caused by catheter and the skin flora adjacent to catheter [10][11][12].…”