Heparin versus normal saline for patency of arterial lines

Robertson‐Malt, Suzanne; Malt, Greg; Farquhar, Vincent; Greer, William

doi:10.1002/14651858.cd007364.pub2

Cited by 22 publications

(24 citation statements)

References 24 publications

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“…Heterogeneity was assessed using the Cochran Q and I 2 statistics. For the Q statistic, a P value<0.10 was considered statistically significant for heterogeneity; for the I 2 statistic, heterogeneity was interpreted as absent (I 2 : 0–25%), low (I 2 : 25.1–50%), moderate (I 2 : 50.1–75%), or high (I 2 : 75.1–100%) [ 18 ]. Subgroup analyses were carried out according to: (i) study quality, (ii) study design (cohort versus case-control studies), (iii) geographic location (Europe vs. Asia vs. North America), and (iv) number of adjustment factors (n ≥5 vs. n ≤6).…”

Section: Methodsmentioning

confidence: 99%

Insulin Use and Risk of Diabetic Macular Edema in Diabetes Mellitus: A Systemic Review and Meta-Analysis of Observational Studies

Zhang

Zhou

et al. 2015

Med Sci Monit

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BackgroundDiabetes mellitus is a common and serious disorder. A search of the literature reveals no comprehensive quantitative assessment of the association between insulin use and incidence of diabetic macular edema. Therefore, we performed a meta-analysis of observational studies to evaluate the effect of insulin use on the risk of developing macular edema.Material/MethodsComparative studies published until May 2014 were searched through a comprehensive search of the Medline, Embase, and the Cochrane Library electronic databases. A systematic review and quantitative analysis of comparative studies reporting the effect of insulin use on the incidence of macular edema was performed. All analyses were performed using the Review Manager (RevMan) v.5 (Nordic Cochrane Centre, Copenhagen, Denmark).ResultsA total of 202 905 individuals were included in the present meta-analysis. In a random-effects meta-analysis, the use of insulin was found to be associated with increased risk of macular edema (RR, 3.416; 95% CI, 2.417–4.829; I2, 86.6%). Analysis that just included high-quality studies showed that insulin use increased the risk of macular edema (RR, 2.728; 95% CI, 1.881–3.955; I2=77.7%). In cohort studies (RR, 4.509; 95% CI, 3.100–6.559; I2, 77.7%) but not in case-control studies (RR, 1.455; 95% CI, 0.520 to 4.066; I2, 95.9%), increased incidence of macular edema was observed.ConclusionsThe results of this meta-analysis of observational studies demonstrate that insulin use is a risk factor for diabetic macular edema. However, available data are still sparse, and in-depth analyses of the assessed associations in the context of additional longitudinal studies are highly desirable to enable more precise estimates and a better understanding of the role of insulin use in incidence of diabetic macular edema.

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Section: Methodsmentioning

confidence: 99%

Insulin Use and Risk of Diabetic Macular Edema in Diabetes Mellitus: A Systemic Review and Meta-Analysis of Observational Studies

Zhang

Zhou

et al. 2015

Med Sci Monit

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“…Heparinized saline solution is known as a common solution in maintaining catheter patency and effectiveness ( 13 ). However, adverse effects of heparinized saline solution and effect of normal saline in maintaining patency of arterial catheter lead to controversy over the type of flush solutions to maintain catheter effectiveness ( 10 , 15 - 17 ). In a recent systematic review, Kordzadeh et al ( 15 ) concluded that heparinized saline solution may be better for long-term use of arterial line.…”

Section: Discussionmentioning

confidence: 99%

“…Normal arterial waveform contains the following components: Ascending slope of systolic arterial pressure, peak systolic arterial pressure, descending slope of systolic arterial pressure, dicrotic notch, continue of blood flow through the artery to the vein based on the pressure gradient and end-diastolic pressure ( 5 ). Heparinized saline solution is widely used to prevent occlusion of arterial catheters in intensive care units ( 10 ). Heparin has effects at multiple sites of the intrinsic and extrinsic coagulation pathways.…”

Section: Introductionmentioning

confidence: 99%

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Avoiding heparinization of arterial line and maintaining acceptable arterial waveform after cardiac surgery: A randomized clinical trial

et al. 2015

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Background:Invasive and continuous blood pressure (BP) monitoring is crucial after cardiac surgery. Accuracy of BP measurement mostly depends on patency of arterial catheter and acceptable waveform. Heparinized saline flush usually used for this purpose may be accompanied by potential heparin adverse effects.Objectives:The aim of this study was to compare heparinized and non-heparinized saline flush to maintain acceptable arterial waveform after cardiac surgery.Materials and Methods:In a double blind randomized trial study, 100 patients undergoing elective cardiac surgery were randomized to using heparinized (n = 50) or non-heparinized (normal) saline flush (n = 50) to maintain patency of arterial catheter after operation. Indwelling arterial catheters were checked daily for acceptable arterial waveform for three days as primary outcome measures.Results:Frequency of acceptable arterial waveform ranged from 66% to 80%, in first, second and third postoperative days. There were no statistically significant differences between heparinized and non-heparinized saline groups regarding acceptable arterial waveforms in all the three postoperative days (all P values > 0.05).Conclusions:Using non-heparinized normal saline is suitable to maintain acceptable arterial waveform for short-term (three days) after adult cardiac surgery considering potential adverse effects of heparin.

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“…7 Normal or isotonic saline has sodium and chloride concentrations of 154 mEq/L. 8 Normal saline solution can maintain patency of arterial and central venous pressure monitoring catheters. Heparinized solutions had no effect on prolonging patency and improving function of catheters and even caused changes in activated partial thromboplastin time (APTT) while the normal saline solution increases accuracy of coagulatory tests.…”

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confidence: 99%

Role of Heparin in Arterial Line Flushing Solution on Platelet Count and Indwelling Arterial Catheter Patency after Cardiac Valvular Surgery

et al. 2018

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Background: Heparin can cause thrombocytopenia but what is it's effect on platelet when used in solution forflushing indwelling arterial catheter is not clear. This study was designed to find out any effect of heparin on platelet count and to see the efficacy of normal solution as flushing solution. Method:Thiswas a prospective randomized comparative clinical trial in the Bangladesh during the period from july 2016 to june 2017. Total sixty patients who underwent single valve replacement surgery were divided into two groups and were evaluated for heparin effect and compared for arterial catheter patency rate. Results: Platelet count on third postoperative day is 226517+-60185/ml and 245957+-52826/ml in heparinized flush solution and normal saline flush solution group respectively. The difference of mean is not significant with p value 0.188. Arterial catheter patency rate was 50.0% in heparinized flush solution group and 43.3% in normal saline flush solution group on third postoperative day which signifies no difference between the groups with p value 0.607. Conclusion: The use of heparin in normal saline in continuous flushing devices for an arterial catheter does not significantly reduce platelet counts in cardiac valve surgery patients in comparison to normal saline. It seems that there is no difference in the use of heparinized and normal saline solutions to maintain indwelling arterial catheter patent.

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Heparin versus normal saline for patency of arterial lines

Cited by 22 publications

References 24 publications

Insulin Use and Risk of Diabetic Macular Edema in Diabetes Mellitus: A Systemic Review and Meta-Analysis of Observational Studies

Insulin Use and Risk of Diabetic Macular Edema in Diabetes Mellitus: A Systemic Review and Meta-Analysis of Observational Studies

Avoiding heparinization of arterial line and maintaining acceptable arterial waveform after cardiac surgery: A randomized clinical trial

Role of Heparin in Arterial Line Flushing Solution on Platelet Count and Indwelling Arterial Catheter Patency after Cardiac Valvular Surgery

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