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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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
Issue number4
Publication statusPublished - Dec 2012



  • Adverse events
  • Heparin
  • Peripheral venous catheters
  • Thrombophlebitis

ASJC Scopus subject areas

  • Nursing(all)
  • Medicine(all)

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