Evaluation of the effects of heparinized and nonheparinized flush solutions on the patency of arterial pressure monitoring lines: the AACN Thunder Project. By the American Association of Critical-Care Nurses.
OBJECTIVE
To evaluate the effects of heparinized and nonheparinized flush solutions on the patency of arterial pressure monitoring lines.


METHODS
A total of 5139 patients from 198 participating sites comprised the sample for this large-scale, randomized clinical trial.


METHODS
Patients were randomly assigned to heparinized and nonheparinized flush solution treatment groups. Data were collected at 4-hour intervals for up to 72 hours on presence of acceptable square waveform and arterial backflow.


RESULTS
Arterial pressure monitoring lines maintained with heparinized flush solutions had a significantly greater probability of remaining patent over time than lines maintained with nonheparinized flush solutions. In addition to heparin, four other variables significantly influenced the probability of lines remaining patent: receiving other anticoagulants or thrombolytics, having a catheter longer than 2 inches, femoral insertion site and male gender.


CONCLUSIONS
Chances for patency are greatest in men with long femoral lines who receive other anticoagulants or thrombolytics and heparinized flush solutions. Risks of nonpatency are greatest in women with short nonfemoral lines who do not receive other anticoagulants or thrombolytics and have nonheparinized flush solutions.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000925:Anticoagulants / Q000627:therapeutic use; D001795:Blood Pressure Determination / Q000295:instrumentation; D002408:Catheters, Indwelling; D015400:Clinical Nursing Research; D015986:Confounding Factors, Epidemiologic; D004867:Equipment Design; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006493:Heparin / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation; D016016:Proportional Hazards Models; D012307:Risk Factors; D012965:Sodium Chloride / Q000008:administration & dosage; D007507:Therapeutic Irrigation / Q000379:methods / Q000451:nursing; D013921:Thrombocytopenia / Q000139:chemically induced / Q000453:epidemiology / Q000401:mortality; D013997:Time Factors; D014654:Vascular Patency
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D012965:Sodium Chloride; D006493:Heparin