Heparin for prolonging peripheral intravenous catheter use in neonates

Benefit and risk of heparin for maintaining peripheral venous catheters in neonates: a placebo-controlled trial

“…Heparin flushes or addition of heparin to the infusion fluid is used to prolong catheter patency. 1 However, no standardized recommendations are available, and prospective studies using heparin flushes gave contradictory results. A meta-analysis evaluating heparin for prolonging peripheral intravenous catheter use in neonates did not result in clear recommendations.…”

“…A meta-analysis evaluating heparin for prolonging peripheral intravenous catheter use in neonates did not result in clear recommendations. 1 The studies using continuous heparin infusion in neonates to prolong catheter patency enrolled either very low numbers of patients or older infants, excluded patients receiving certain antibiotics, or restricted inclusion to certain catheter sizes. [2][3][4][5] Moclair and Bates 3 compared catheter patency when 0.1 IU/mL, 0.25 IU/mL, 0.5 IU/mL, or 1 IU/mL heparin was added to continuous infusion.…”

S3-Leitlinie der Deutschen Gesellschaft für Ernährungsmedizin (DGEM) in Zusammenarbeit mit der Gesellschaft für klinische Ernährung der Schweiz (GESKES), der Österreichischen Arbeitsgemeinschaft für klinische Ernährung (AKE), die Deutsche Gesellschaft für Kinder- und Jugendmedizin (DGKJ) und die Gesellschaft für Neonatologie und pädiatrische Intensivmedizin (GNPI)

“…Medikamente und der erwarteten Dauer der parenteralen Ernährung. Zwei Metaanalysen zeigten keinen positiven Effekt eines Heparinzusatzes auf ZVK-Anwendungsdauer oder Thrombenbildung bei Neonaten, die mit perkutanen zentralen Venenkathetern versorgt waren [274,275].…”

Catheter, Cohort, Complications and Confounding Factors?

“…Furthermore, the use of 10 U/ml heparin as an intermittent flush seems to be no more effective than normal saline. Also in neonates, because the effect of heparin on the duration of PIVC use varies across studies, no definite recommendations can be made [15]. Because of clinical heterogeneity and heterogeneity in treatment effect, recommendations for heparin use with PIVCs cannot be made.…”