Randomized controlled trial of heparin for prevention of blockage of peripherally inserted central catheters in neonates.
OBJECTIVE
To determine whether the addition of heparin to total parenteral nutrition (TPN) fluid would prevent blockage of peripherally inserted central catheters (PICCs) in neonates.


METHODS
This was a randomized, double-blind, controlled study of 66 eligible neonates with PICCs inserted for the administration of TPN. Infants were randomized to receive TPN containing either 1 IU ml(-1) of heparin (n = 35) or no heparin (n = 31).


RESULTS
There was no significant difference in the incidence of blocked catheters between the two groups of infants (heparin: 14.3%; no-heparin: 22.6%, p = 0.4). Although a higher percentage (62.9%) of infants in the heparin group received a complete course of TPN successfully via PICC than those in the no-heparin group (48.4%), the difference was not statistically significant (p = 0.3). There were no significant differences in the incidence of catheter-related sepsis, hypertriglyceridaemia, hyperbilirubinaemia, coagulopathy or intraventricular haemorrhage between the two groups.


CONCLUSIONS
Addition of heparin to TPN fluid was not associated with a significant reduction in the incidence of blocked PICCs. However, the sample size of this study was too small to exclude even rather marked differences between the groups.
Kamala
F
F
Department of Paediatrics, Hospital Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Boo
N Y
NY
Cheah
F C
FC
Birinder
K
K
D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods; D002406:Catheterization, Peripheral / Q000009:adverse effects; D004311:Double-Blind Method; D005260:Female; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010289:Parenteral Nutrition, Total / Q000295:instrumentation; D018805:Sepsis / Q000209:etiology
D006493:Heparin