Routine Catheter Lock Solutions in Pediatric Cancer Care: A Pilot Randomized Controlled Trial of Heparin vs Saline.
Amanda J Ullman, Rachel Edwards, Rick Walker and 12 others
PMID 35131974WHAT IT FOUND
This pilot did not show a difference between saline and heparin locks for pediatric cancer CVAD occlusion.
Heparin had more occlusions descriptively, but the study was too small to decide.
Key findings
01Heparin locks had 2 complete and 7 partial occlusions, while saline locks had 4 partial occlusions and no complete occlusions; the differences were not statistically significant.
02Eligibility and recruitment feasibility targets were not met (52% and 54%), but protocol fidelity was 95% and there was no attrition or missing data.
03The incremental cost difference between groups was $258.17 and was not statistically significant (P = .255).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was a pilot feasibility trial and was not powered to detect clinical differences in occlusion or complications. It was single-center, short-term (up to 6 weeks), and excluded children receiving PEG-asparaginase, regional or home-care patients, and intensive care patients. Eligibility and recruitment rates were below prespecified targets. Patients, clinical staff, and research nurses were not blinded to allocation. The authors note some baseline imbalance in diagnosis, lumens, and tip position.
Declared interests
Funded by Children's Hospital Foundation. No additional conflicts of interest are reported in the supplied text.
The easy way to misread this
Do not conclude that the lock solution alone caused the occlusion differences. This pilot was not powered for clinical outcomes, and the occlusion differences were not statistically significant. The authors also note that flushing technique, not only the lock solution, may affect catheter patency.