Heparin versus normal saline locking for prevention of occlusion, catheter-related infections and thrombosis in central venous catheter in adults: Overview of systematic reviews.

Q3 Medicine JAVA - Journal of the Association for Vascular Access Pub Date : 2024-11-01 Epub Date: 2022-06-10 DOI:10.1177/11297298221103201
Isabella Santomauro, Daiana Campani, Valentina Tiozzo, Barbara Barletta, Lorenza Scotti, Michela Barisone, Alberto Dal Molin
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Abstract

Venous access devices are used in health care. To prevent occlusions the evidence confirmed the need for routine catheter flushing before and after infusion as well as at the end of use. To date, the efficacy of heparin has not been demonstrated. The aim of this study was to evaluate the effectiveness of the locking of central venous catheters with heparin versus normal saline in adults to prevent occlusion, catheter-related infections and thrombosis in adults. A literature search using Medline, Embase, Cochrane Library and Cinahl was performed to identify all meta-analyses addressing the effectiveness of heparin versus normal saline in locking central venous catheters in adults. Four reviewers independently selected publications assessed quality and extracted data. Parameter estimates regarding occlusion, catheter- related infections and thrombosis were pooled using an umbrella review. We identified 6356 references. Seven systematic reviews were included in the study. Most of the studies included in the systematic reviews were conducted in oncohaematology departments, intensive care and cardiac surgery units among patients with multiple diseases and chronicity. Most studies report a heparin concentration of 10 to 5000 IU/ml versus normal saline and other solutions. There was no evidence that heparin was more effective than normal saline in reducing complications such as occlusion, catheter-related infections and thrombosis. No statistically significant difference was found between heparin and normal saline in reducing catheter occlusion. Heparin is not superior compared to normal saline.

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肝素与生理盐水锁闭预防成人中心静脉导管闭塞、导管相关感染和血栓形成:系统综述。
静脉通路装置用于医疗保健。为防止闭塞,有证据证实有必要在输液前后和使用结束时对导管进行常规冲洗。迄今为止,肝素的功效尚未得到证实。本研究旨在评估用肝素锁定成人中心静脉导管与用生理盐水锁定成人中心静脉导管对预防成人中心静脉导管闭塞、导管相关感染和血栓形成的效果。我们使用 Medline、Embase、Cochrane 图书馆和 Cinahl 进行了文献检索,以确定所有关于肝素与生理盐水对成人中心静脉导管锁定效果的荟萃分析。四位审稿人独立选择出版物,评估质量并提取数据。采用总括回顾法对有关闭塞、导管相关感染和血栓形成的参数估计进行了汇总。我们确定了 6356 篇参考文献。其中包括七篇系统综述。纳入系统综述的大多数研究都是在肿瘤科、重症监护室和心脏外科进行的,研究对象是患有多种疾病和慢性病的患者。大多数研究报告称,肝素浓度为 10 至 5000 IU/ml,而正常生理盐水和其他溶液的肝素浓度为 10 至 5000 IU/ml。没有证据表明肝素在减少闭塞、导管相关感染和血栓形成等并发症方面比生理盐水更有效。在减少导管闭塞方面,肝素与生理盐水之间没有明显的统计学差异。肝素与生理盐水相比并无优势。
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来源期刊
JAVA - Journal of the Association for Vascular Access
JAVA - Journal of the Association for Vascular Access Medicine-Medicine (miscellaneous)
CiteScore
1.10
自引率
0.00%
发文量
22
期刊介绍: The Association for Vascular Access (AVA) is an association of healthcare professionals founded in 1985 to promote the emerging vascular access specialty. Today, its multidisciplinary membership advances research, professional and public education to shape practice and enhance patient outcomes, and partners with the device manufacturing community to bring about evidence-based innovations in vascular access.
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