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Effectiveness of heparin solution versus normal saline in maintaining patency of intravenous locks in neonates: a double blind randomized controlled study

Authors

  • Inge J. J. Arnts,

    1. Inge J. J. Arnts RN MANP Nurse Practitioner, Investigator Department of Neonatology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
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  • Johanna A. Heijnen,

    1. Johanna A. Heijnen RN Clinical Nurse Specialist Department of Neonatology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
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  • Henriette T. M. Wilbers,

    1. Henriette T. M. Wilbers MSc RN Investigator Department of Neonatology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
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  • Gert-Jan van der Wilt,

    1. Gert-Jan van der Wilt PhD Professor Department of Epidemiology, Biostatistics and Health Technology Assessment, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
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  • Johannes M. M. Groenewoud,

    1. Johannes M. M. Groenewoud MSc Biostatistician Department of Epidemiology, Biostatistics and Health Technology Assessment, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
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  • Kian D. Liem

    1. Kian D. Liem MD PhD Associate Professor Department of Neonatology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
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I.J.J. Arnts: e-mail: i.arnts@cukz.umcn.nl

Abstract

arnts i.j.j., heijnen j.a., wilbers h.t.m., van der wilt g.j., groenewoud j.m.m. & liem k.d. (2011) Effectiveness of heparin solution versus normal saline in maintaining patency of intravenous locks in neonates: a double blind randomized controlled study. Journal of Advanced Nursing67(12), 2677–2685.

Abstract

Aim.  The aim of this study was to evaluate the effect of heparin versus saline as flush solution for maintaining patency in peripheral intravenous locks in neonates and to investigate whether other variables influence the longevity of intravenous locks.

Background.  Heparin is usually used as a regular flush solution to prevent occlusion of peripheral intravenous locks in neonates. There is no clear recommendation using heparin or saline flushing peripheral intravenous locks in neonates. The disadvantage of heparin cannot be ignored, especially in this patient group.

Methods.  In a double blind prospective randomized study, neonates (gestational age >27 weeks) with intravenous locks were randomly assigned to receive heparin or saline as a flush solution in a 21-month period (2002–2004). The main outcome was the duration of patency.

Results.  Eighty-eight neonates were included. No statistically significant difference was found in patency of peripheral intravenous locks flushed with 0·7 mL heparin (10 units/mL) (N = 42, median 56 hours) or 0·7 mL saline (N = 46, median 61 hours). When the analysis was confined to removed locks because of non-elective events, no statistically significant difference was found in duration of patency (P = 0·27).

Conclusion.  As no difference in patency could be established, using saline as a flush solution is preferable to heparin in peripheral intravenous locks in neonates, given the greater likelihood of complications associated with heparin. Although these data are more than 5 years old, the relevance of the outcome is still important for the clinical practice because of the potential adverse effects of heparin in these vulnerable infants.

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