Effectiveness of heparin versus 0.9% saline solution in maintaining the permeability of central venous catheters: a systematic review

  • Eduardo José Ferreira dos Santos Escola Superior de Enfermagem de Coimbra; Unidade de Investigação em Ciências da Saúde
  • Maria Madalena Jesus Cunha Nunes Instituto Politécnico de Viseu; Centro de Estudos em Educação, Tecnologias e Saúde
  • Daniela Filipa Batista Cardoso Escola Superior de Enfermagem de Coimbra; Unidade de Investigação em Ciências da Saúde
  • João Luís Alves Apóstolo Escola Superior de Enfermagem de Coimbra; Unidade de Investigação em Ciências da Saúde
  • Paulo Joaquim Pina Queirós Escola Superior de Enfermagem de Coimbra; Unidade de Investigação em Ciências da Saúde
  • Manuel Alves Rodrigues Escola Superior de Enfermagem de Coimbra; Unidade de Investigação em Ciências da Saúde

Abstract

OBJECTIVE Determining which is the most effective solution (heparin flush compared to 0.9% saline flush) for reducing the risk of occlusions in central venous catheters (CVC) in adults. METHOD The systematic review followed the principles proposed by the Cochrane Handbook; critical analysis, extraction and synthesis of data were performed by two independent researchers; statistical analysis was performed using the RevMan program 5.2.8. RESULTS Eight randomized controlled trials and one cohort study were included and the results of the meta-analysis showed no difference (RR=0.68, 95% CI=0.41-1.10; p=0.12). Analysis by subgroups showed that there was no difference in fully deployed CVC (RR=1.09, CI 95%=0.53-2.22;p=0.82); Multi-Lumen CVC showed beneficial effects in the heparin group (RR=0.53, CI 95%=0.29-0.95; p=0.03); in Double-Lumen CVC for hemodialysis (RR=1.18, CI 95%=0.08-17.82;p=0.90) and Peripherally inserted CVC (RR=0.14, CI 95%=0.01-2.60; p=0.19) also showed no difference. CONCLUSION Saline solution is sufficient for maintaining patency of the central venous catheter, preventing the risks associated with heparin administration.

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Published
2015-12-01
How to Cite
Santos, E., Nunes, M., Cardoso, D., Apóstolo, J., Queirós, P., & Rodrigues, M. (2015). Effectiveness of heparin versus 0.9% saline solution in maintaining the permeability of central venous catheters: a systematic review . Revista Da Escola De Enfermagem Da USP, 49(6), 995-1003. https://doi.org/10.1590/S0080-623420150000600017
Section
Critical Review