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Normal salin versus heparin for maintenance of central venous catheter patency |
Journal de Pharmacie Clinique. Volume 28, Number 4, 181-7, octobre-novembre-décembre 2009, Article original
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 Résumé
Texte intégral
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Author(s) : F Ermine, K Touzin, J Bibeau, K Houle, J-F Bussières |
Summary : Objective: To compare the efficacy of sodium chloride 0.9% with heparin-lock to maintain venous catheter patency. Methods: This is a descriptive study. From a literature search in PubMed and Medline, we identified all clinical studies, systematic reviews and meta-analysis published between 1991 and 2009. Therefore, we collected data regarding the use of heparin 100 units/mL for venous central catheter maintenance in our hospital through meetings with chief-assistant nurses in targeted clinical settings. Results: 18 relevant articles which met our inclusion criteria were selected from our literature search. These studies show that sodium chloride 0.9% can prevent adverse events from heparin (e.g. thrombocytopenia, allergy, hemorragia) and help avoid overdoses by wrong concentration selection or compounding manipulation error. However, heparin seems to be a more effective choice. Most studies revealed that heparin were marginally or significantly superior to sodium chloride for venous catheter patency maintenance. Our round on clinical wards allowed us to point out the interest from clinical staff for an eventual switch to sodium chloride from heparin, despite the identification of clinical concerns. Conclusion: There is a controversy regarding the comparable efficacy of sodium chloride and heparin lock. Prospective randomized controlled studies are required to evaluate the clinical interest and the cost-effectiveness ratio of both agents and to identify net benefits to use sodium chloride. |
Keywords : normal saline, heparin, central venous catheter, patency, maintenance, efficacy |
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