Effects of heparin versus saline solution on intermittent infusion device irrigation.
ABSTRACT The purpose of this study was to compare the effectiveness of 1 ml of 0.9% sodium chloride with 10 units of heparin in 1 ml sodium chloride solution, both containing benzyl alcohol, in maintaining patency and reducing the incidence of phlebitis in patients with intermittent infusion devices. The subjects (N = 32) were randomly assigned in a double-blind experimental design. Repeated-measures analysis of variance revealed no significant difference between the groups in phlebitis or patency variables. The results from this controlled study would suggest that 0.9% sodium chloride is as effective as 10 units of heparin in sodium chloride solution in maintaining intermittent infusion device patency and preventing phlebitis.
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ABSTRACT: Heparin is used as a flush solution for intravenous and intra-arterial lines, but has a number of drug interactions, as well as potentially serious side effects. We compared the function of arterial lines for both monitoring and blood sampling when flushed with either normal saline or saline containing heparin (1 unit/mL). Sixty-five patients were recruited at this mixed medical and surgical Level 2 intensive care unit. Patients were randomised to receive either normal saline (NS) or heparinised saline (HS) (3 mL/hour as a continuous flush). Each patient's nurse was asked to score the function of the line at the end of each nursing shift. 35 patients were recruited in the NS group and 30 in the HS group. Mean study duration was 5.8 and 6.6 days for the NS and HS groups, respectively. The scores for the intravascular line for each patient were summed, and the percentage of the total possible score was calculated. Mean percentage scores were 83% (NS group) and 82% (HS group). Comparison using the central limit theorem showed no difference between the groups at the 95% confidence interval (-6% to 10%). Heparin as a continuous flush at 3 units/hour does not improve the function of arterial lines compared with a continuous normal-saline flush.Critical care and resuscitation: journal of the Australasian Academy of Critical Care Medicine 10/2006; 8(3):205-8. · 1.51 Impact Factor
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ABSTRACT: To design, implement, and to evaluate the outcomes of an evidence-based practice change regarding the use of heparin in intravenous (IV) locks to improve patient safety. Phase I of the project examined dwell time, hours of patency, gestational age at birth and at time of IV lock insertion, birthweight and weight at time of insertion, and reason for discontinuation for IV access devices prior to and following the practice change from heparinized saline (HS) to normal saline (NS) flush. Phase II of the project was to determine the effect of the educational program on staff knowledge of the use of heparinized saline vs normal saline flushes. The setting was an 18 bed level III NICU located in the northeastern United States. A sample of 70 infants with IV locks were included in the study; HS (n = 34) and NS (n = 36) respectively. Infants with IV's that were converted to IV locks were excluded. Only professional NICU staff (n = 40) were recruited for the educational offering. A comparative descriptive design with two components was utilized. A retrospective and prospective chart review was used to compare the outcomes of neonates with IV locks flushed with heparin and normal saline flush and evaluated the outcomes. A pretest/posttest design was used to analyze the change of the NICU staff's knowledge concerning heparin flush before and after an educational offering. IV lock patency after practice change to NS flush and the change of the NICU staff's knowledge concerning heparin flush after an educational offering. There was a statistically significant difference in IV catheter patency with NS flushed catheters averaging 13 hours longer than HS flushed catheters (p = 0.02). Also a statistically significant increase in mean scores was noted for the NICU staff posttest after the educational offering (p = .0001). There was a 20% increase in knowledge scores. Findings from this project support the current literature base suggesting that the use of heparin is unnecessary for the maintenance of IV access devices. Unnecessary exposure of neonates to heparin increases risk to patient safety and should therefore be avoided. Future research should examine the use of heparin in central lines in neonates. Findings additionally support educating staff prior to practice changes.Advances in Neonatal Care 06/2011; 11(3):208-15.
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ABSTRACT: Heparin solution is routinely used to maintain the patency of infusion devices. Literature supports the alternative use of normal saline solution for flushing and locking intravenous infusion devices especially for pediatric patients. There is uncertainty regarding safety and efficacy of this policy for intermittent locking of implanted ports. This study evaluates efficacy and safety of normal saline solution for intermittent locking procedures of implanted ports. This is a retrospective observational cohort study of 610 implanted ports receiving 2 different locking solutions conducted at the National Institute for Cancer Research, IST Genova, Italy, from January 2007 to August 2009. Group A (n = 297) received heparinized solution (10 mL/500 U heparin), whereas group B (n = 313), 10 mL normal saline. Primary endpoint was irreversible port occlusion. Minimum follow-up was 12 months. The role of age, type of tumor, disease stage, access site, access body side, catheter tip position, and concomitant use of parenteral nutrition and chemotherapy was evaluated in secondary aim. : Results fail to show statistically significant differences in implanted ports survival free from failure for occlusive events between the use of heparinized solution and that of normal saline for the maintenance of port patency, both in univariate (P = .9) and in multivariate analyses (P = .7). Normal saline solution seems to be as effective as heparinized solution for keeping patent implanted ports in adult cancer patients. Switching from heparinized solution to normal saline for catheter intermittent lock of ports seems a safe procedure.Cancer nursing 01/2012; 35(4):E35-42. · 1.88 Impact Factor