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

Abstract

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

Evidence on port-locking with heparin versus saline in patients with cancer not receiving chemotherapy: A randomized clinical trial

“…Finally, the most recent Cochrane reviews by Zhong et al and by López-Briz et al, are in keeping with our results, report that the use of heparin for maintaining intermittent catheters may have little to no effect on the duration of the catheter's patency. 18 , 21 The use of higher concentrations of heparin, similarly, did not yield conclusive results or show any evidence of difference in the safety of maintenance methods about the risk of sepsis, mortality, or hemorrhage. 5 , 26 …”

“…11 Finally, the most recent Cochrane reviews by Zhong et al and by L opez-Briz et al, are in keeping with our results, report that the use of heparin for maintaining intermittent catheters may have little to no effect on the duration of the catheter's patency. 18,21 The use of higher concentrations of heparin, similarly, did not yield conclusive results or show any evidence of difference in the safety of maintenance methods about the risk of sepsis, mortality, or hemorrhage. 5,26 In summary, the study demonstrated that ports can be locked either with heparin every 4 months or with saline every 2 months compared to the standard of heparin every 2 months according to no differences in infection, thrombosis, and occlusion rates.…”

“… 6 Italian researchers achieved the same conclusions with heparinization every 4 weeks vs. every 8 weeks and no statistically significant differences for occlusion, 17 and when comparing heparin with saline in a Cochrane systematic review, the best option was saline, although with limitations due to small sample size. 18 , 21 …”

“…6 Italian researchers achieved the same conclusions with heparinization every 4 weeks vs. every 8 weeks and no statistically significant differences for occlusion, 17 and when comparing heparin with saline in a Cochrane systematic review, the best option was saline, although with limitations due to small sample size. 18,21 Another question raised is the variability of care for ports and the use of heparin for patency described in intensive care units and patients with cancer. [19][20][21] Initially, the administration of heparin 500 IU (control) vs. 100 IU (experimental) demonstrated that lower dose was equally effective in central lines.…”

Implementation of an Evidence-Based Practice Change Removing Heparin From Implanted Vascular Access Devices

“…2 However, literature continues to emerge suggesting that this may not be as essential as once purported and that 0.9% normal saline could be as effective in the prevention of occlusion. This was highlighted in a 2018 update of a Cochrane Review meta-analysis by Lopez-Briz et al, 8 including 11 studies with 2392 participants, and a 2017 systematic review and meta-analysis by Zhong et al, 9 with 10 randomized controlled trials involving 7875 subjects. These 2 studies found no differences between heparin and normal saline in occlusion.…”