Keeping central venous lines open: a prospective comparison of heparin, vitamin C and sodium chloride sealing solutions in medical patients.
OBJECTIVE
To prevent catheter occlusion, intermittently used central venous catheters are frequently sealed with vitamin C solution or heparin solution between use. The present study was designed to test the effectiveness of this approach and to compare the efficiency of sealing solutions.


METHODS
Prospective randomized study performed on a 9-bed medical ICU and on medical wards of an academic tertiary care center. PARTICIPANTS. Ninety-nine central venous line placements were prospectively included in the study and randomized into three treatment groups: sodium chloride 0.9%, vitamin C (200 mg/ml) and heparin (5000 IU/ml) sealing solutions.


METHODS
Catheters were filled with the respective sealing solution and patency was tested once every 2 days using a standardized routine. Catheter patency was compared among the three groups using Kaplan-Meier statistics and log-rank testing.


RESULTS
There was a significant difference in catheter patency between the three groups (p<0.03, log-rank test). A comparison of catheter survival between the catheters filled with heparin and those filled with sodium chloride, but not between those filled with vitamin C solution and with sodium chloride solution, exhibited significant differences in catheter patency (p<0.04, log-rank test).


CONCLUSIONS
Local anticoagulation of intermittently used central venous catheters prolongs catheter patency. High-dose (5000 IU/ml) heparin solution is a useful anticoagulant for this purpose, while vitamin C solution does not prolong catheter patency.
Rabe
Christian
C
Department of Medicine I, University of Bonn, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany. Rabe@uni-bonn.de
Gramann
Tobias
T
Sons
Ximena
X
Berna
Marc
M
González-Carmona
María Angeles
MA
Klehr
Hans-Ulrich
HU
Sauerbruch
Tilman
T
Caselmann
Wolfgang H
WH
D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D001205:Ascorbic Acid / Q000008:administration & dosage*; D002405:Catheterization, Central Venous / Q000379:methods*; D002408:Catheters, Indwelling; D004868:Equipment Failure; D005260:Female; D005858:Germany; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage*; D007507:Therapeutic Irrigation
D000925:Anticoagulants; D012965:Sodium Chloride; D006493:Heparin; D001205:Ascorbic Acid