Intermittent Flushing with Heparin Versus Saline for Maintenance of Peripheral Intravenous Catheters in a Medical Department: A Pragmatic Cluster-Randomized Controlled Study

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18 Citations (Scopus)

Abstract

Background: Three meta-analyses conducted in the 1990s concluded that the effect of intermittent flushing with heparin at low concentration (10 U/mL) was equivalent to that of 0.9% sodium chloride flushes in preventing occlusion or superficial phlebitis. No firm conclusion was reached on the safety and efficacy of heparin concentrations of 100 U/mL used as an intermittent flush. Purpose: To determine whether flushing peripheral intravenous catheters with 3 mL of a 100 U heparin/mL solution instead of saline improves the outcome of infusion devices. Methods: Cluster-randomized, controlled, two-arm, open trial, conducted in a research and teaching hospital in Northern Italy, involving 214 medical patients without contraindications to heparin: 107 randomly allocated to heparin and 107 to saline flushes (control group). Main outcome measure was catheter occlusion and catheter-related phlebitis. Results: Patients with either phlebitis or occlusion were 45 (42.1%) in the heparin group and 68 (63.6%) in the saline group (OR 0.41; 95% CI 0.24-0.72; p= 0.002); patients with occlusion alone were 23 (21.5%) and 47 (43.9%), respectively (p= 0.03); patients with phlebitis alone were 28 (26.2%) and 56 (52.6%) respectively (p=

Original languageEnglish
Pages (from-to)221-226
Number of pages6
JournalWorldviews on Evidence-Based Nursing
Volume9
Issue number4
DOIs
Publication statusPublished - Dec 2012

Fingerprint

Heparin
Phlebitis
Catheters
Maintenance
Sodium Chloride
Teaching Hospitals
Italy
Meta-Analysis
Outcome Assessment (Health Care)
Safety
Equipment and Supplies
Control Groups
Research

Keywords

  • Adverse events
  • Heparin
  • Peripheral venous catheters
  • Thrombophlebitis

ASJC Scopus subject areas

  • Nursing(all)
  • Medicine(all)

Cite this

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title = "Intermittent Flushing with Heparin Versus Saline for Maintenance of Peripheral Intravenous Catheters in a Medical Department: A Pragmatic Cluster-Randomized Controlled Study",
abstract = "Background: Three meta-analyses conducted in the 1990s concluded that the effect of intermittent flushing with heparin at low concentration (10 U/mL) was equivalent to that of 0.9{\%} sodium chloride flushes in preventing occlusion or superficial phlebitis. No firm conclusion was reached on the safety and efficacy of heparin concentrations of 100 U/mL used as an intermittent flush. Purpose: To determine whether flushing peripheral intravenous catheters with 3 mL of a 100 U heparin/mL solution instead of saline improves the outcome of infusion devices. Methods: Cluster-randomized, controlled, two-arm, open trial, conducted in a research and teaching hospital in Northern Italy, involving 214 medical patients without contraindications to heparin: 107 randomly allocated to heparin and 107 to saline flushes (control group). Main outcome measure was catheter occlusion and catheter-related phlebitis. Results: Patients with either phlebitis or occlusion were 45 (42.1{\%}) in the heparin group and 68 (63.6{\%}) in the saline group (OR 0.41; 95{\%} CI 0.24-0.72; p= 0.002); patients with occlusion alone were 23 (21.5{\%}) and 47 (43.9{\%}), respectively (p= 0.03); patients with phlebitis alone were 28 (26.2{\%}) and 56 (52.6{\%}) respectively (p=",
keywords = "Adverse events, Heparin, Peripheral venous catheters, Thrombophlebitis",
author = "Giampiera Bertolino and Antonietta Pitassi and Carmine Tinelli and Andrea Staniscia and Barbara Guglielmana and Luigia Scudeller and {Luigi Balduini}, Carlo",
year = "2012",
month = "12",
doi = "10.1111/j.1741-6787.2012.00244.x",
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T1 - Intermittent Flushing with Heparin Versus Saline for Maintenance of Peripheral Intravenous Catheters in a Medical Department

T2 - A Pragmatic Cluster-Randomized Controlled Study

AU - Bertolino, Giampiera

AU - Pitassi, Antonietta

AU - Tinelli, Carmine

AU - Staniscia, Andrea

AU - Guglielmana, Barbara

AU - Scudeller, Luigia

AU - Luigi Balduini, Carlo

PY - 2012/12

Y1 - 2012/12

N2 - Background: Three meta-analyses conducted in the 1990s concluded that the effect of intermittent flushing with heparin at low concentration (10 U/mL) was equivalent to that of 0.9% sodium chloride flushes in preventing occlusion or superficial phlebitis. No firm conclusion was reached on the safety and efficacy of heparin concentrations of 100 U/mL used as an intermittent flush. Purpose: To determine whether flushing peripheral intravenous catheters with 3 mL of a 100 U heparin/mL solution instead of saline improves the outcome of infusion devices. Methods: Cluster-randomized, controlled, two-arm, open trial, conducted in a research and teaching hospital in Northern Italy, involving 214 medical patients without contraindications to heparin: 107 randomly allocated to heparin and 107 to saline flushes (control group). Main outcome measure was catheter occlusion and catheter-related phlebitis. Results: Patients with either phlebitis or occlusion were 45 (42.1%) in the heparin group and 68 (63.6%) in the saline group (OR 0.41; 95% CI 0.24-0.72; p= 0.002); patients with occlusion alone were 23 (21.5%) and 47 (43.9%), respectively (p= 0.03); patients with phlebitis alone were 28 (26.2%) and 56 (52.6%) respectively (p=

AB - Background: Three meta-analyses conducted in the 1990s concluded that the effect of intermittent flushing with heparin at low concentration (10 U/mL) was equivalent to that of 0.9% sodium chloride flushes in preventing occlusion or superficial phlebitis. No firm conclusion was reached on the safety and efficacy of heparin concentrations of 100 U/mL used as an intermittent flush. Purpose: To determine whether flushing peripheral intravenous catheters with 3 mL of a 100 U heparin/mL solution instead of saline improves the outcome of infusion devices. Methods: Cluster-randomized, controlled, two-arm, open trial, conducted in a research and teaching hospital in Northern Italy, involving 214 medical patients without contraindications to heparin: 107 randomly allocated to heparin and 107 to saline flushes (control group). Main outcome measure was catheter occlusion and catheter-related phlebitis. Results: Patients with either phlebitis or occlusion were 45 (42.1%) in the heparin group and 68 (63.6%) in the saline group (OR 0.41; 95% CI 0.24-0.72; p= 0.002); patients with occlusion alone were 23 (21.5%) and 47 (43.9%), respectively (p= 0.03); patients with phlebitis alone were 28 (26.2%) and 56 (52.6%) respectively (p=

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