Santos EJFD, Nunes MMJC, Cardoso DFB, Apóstolo JLA, Queirós PJP, Rodrigues MA. [Effectiveness of heparin versus 0.9% saline solution in maintaining the permeability of central venous catheters: a systematic review].
Rev Esc Enferm USP 2016;
49:999-1007. [PMID:
27419685 DOI:
10.1590/s0080-623420150000600017]
[Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 08/03/2015] [Indexed: 11/22/2022] Open
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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