Heparin solution in the prevention of occlusions in Hickman® catheters a randomized clinical trial.
Sandra Regina da Silva, Mitzy Tannia Reichembach, Letícia Pontes and 2 others
PMID 33439945WHAT IT FOUND
Heparin blocking solution kept Hickman catheters open longer than saline in stem cell transplant patients.
The small trial showed fewer occlusions, but it does not show this applies to other catheters or patients.
Key findings
01In the white catheter route, the heparin group had complete occlusion (14.28%), while the saline group had nine occlusions: three complete (30%) and six without reflux (60%), with a significant difference (p=0.006).
02Mean days until occlusion on the white route were 52 in the heparin group and 13.46 in the saline group (p<0.001).
03On the red route, the heparin group had no occlusion, while the saline group had five occlusions: one complete (10%) and four without reflux (40%).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 17 catheters (34 lumens) were analyzed. Five eligible catheters were excluded after randomization because they were not Hickman catheters. Three catheters had follow-up breaks before the outcome. The study was done in a bone marrow transplant unit with a convenience sample. It measured catheter occlusion only. Occlusion outcome definitions differed from other studies.
Declared interests
The supplied text does not report funding or conflict-of-interest declarations. The hospital pharmacy service prepared and coded the syringes, and the code envelope was held until after data analysis.
The easy way to misread this
Do not conclude that heparin should replace saline for all central venous catheters. This trial studied only 17 Hickman catheters in stem cell transplant patients, and it measured catheter occlusion only.