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Effectiveness of heparin versus 0.9% saline solution in maintaining the permeability of central venous catheters: a systematic review* * Extracted from the dissertation "Eficácia da heparina e do soro fisiológico para manter a permeabilidade dos cateteres venosos centrais em adultos," Escola Superior de Saúde de Viseu, 2015.

Efectividad de la heparina y el suero fisiológico para mantener la permeabilidad de los catéteres venosos centrales: revisión sistemática

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.

Descriptors
Catheterization, Central Venous; Heparin; Sodium Chloride; Central Venous Catheters; Review

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