The Effects of Heparin Versus Normal Saline for Maintenance of Peripheral Intravenous Locks in Pregnant Women

Necessity of heparin for maintaining peripheral venous catheters: A systematic review and meta-analysis

“…Notwithstanding these benefits, administration of heparin may result in potential complications such as bleeding, thrombocytopenia and allergy (51)(52)(53). These drawbacks may discourage the clinical use of heparin at higher concentrations, although the morbidity of the complications has been low in previous observations (7,13,16,51,53).…”

“…As a classical anticoagulant-medicine, heparin is considered to prevent the formation of thrombus within the indwelling catheter while being used as a flushing or locking solution (3)(4)(5)(6). However, other studies have reported no additional benefits from heparin compared to normal saline in promoting catheter patency (7)(8)(9). A previous systematic review and meta-analysis of randomized controlled trials (RCTs) indicated that intermittent flushing with heparin was not superior to normal saline in reducing catheter occlusion, whereas low dose infusion with heparin may improve the catheter patency and prevent phlebitis (4).…”

“…Finally, 32 studies were found to comply with the predefined inclusion criteria. The characteristics of the final 32 studies included in the present review are displayed in Table I, among which, there are 21 reported results for intermittent flushing (7)(8)(9)(14)(15)(16)(17)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33) and 11 evaluated heparin for continuous infusion (34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44).…”

“…In total, 10 studies reported multiple catheters per patient (15)(16)(17)23,25,27,(37)(38)(39)43), with the rest of the studies reported a single catheter per patient. The study populations included pediatric patients (14,15,21-24, 26-29,32,33,37-39,44), healthy volunteers and adults (7)(8)(9)16,17,20,30,31,(34)(35)(36)(40)(41)(42)(43), and the administered treatments in all studies primarily consisted of antibiotics and parenteral nutrition. Furthermore, the origin of countries reported included the USA (7,8,14,20,(26)(27)(28)30,32,33,35,43), the UK (39,40), Germany (38), France (36), the Netherlands (22), Australia (44), Italy (17), Canada (25), Ireland (34), India (15,31) and China (16)<...>…”

ASHP Therapeutic Position Statement on the Institutional Use of 0.9% Sodium Chloride Injection To Maintain Patency of Peripheral Indwelling Intermittent Infusion Devices

“…35 A subsequent study of pregnant women found no significant differences in the number of patent catheters or in complications with catheters flushed with either heparin or 0.9% sodium chloride, but the authors noted that their small sample size provided only 11% power to detect a significant difference in patency and even less power to detect a significant difference in complications. 36 Data from pregnant patients are conflicting; therefore, a recommendation cannot be made until more data are available.…”