Heparinized solution vs. saline solution in the maintenance of arterial catheters: a double blind randomized clinical trial.
OBJECTIVE
The objectives were to analyze the effectiveness of heparinized solution vs. saline solution for the maintenance of arterial catheters and to detect changes in the activated partial thromboplastin time (aPTT) and platelet count in the samples extracted from both groups of arterial catheters.


METHODS
Randomized, double blind, placebo-controlled clinical trial.


METHODS
Intensive Care Unit of a third-level hospital in Terrassa, Barcelona, Spain.


METHODS
One hundred and thirty-three patients were included in the trial. The selection criteria were: adults, informed consent, not receiving either full-dose anticoagulant or fibrinolytic treatment, and no thrombocytopenia.


METHODS
Sixty-five patients received heparinized solution (1 IU/ml) and 68 received saline solution.


METHODS
Arterial catheter functionality was compared in the groups every 8 h and at catheter removal. Patency, reliability of arterial pressure, and curve quality were used to evaluate the functionality of the catheters. Blood was drawn, discarding 7.5 ml, from the arterial catheter and from the venouscatheter simultaneously for coagulation tests.


RESULTS
The median duration of catheters being in place was 5.1 days (IQR = 8.1) in the heparin group, and 5.4 (IQR = 7.3) in the saline group (p = 0.7). Kaplan-Meier curves showed no differences between groups (p = 0.6). The number of manipulations required to maintain the patency of the arterial catheters was 35% vs. 40% (p = 0.5). The heparin group had a significantly longer aPTT (2.1 +/- .3 vs. 1.25 +/- 0.3, p = 0.001).


CONCLUSIONS
The use of heparinized solution for arterial catheter maintenance doesnot appear to be justified. It did not increase the duration of the catheters, nor did it improve their functionality significantly. On the other hand, heparin Na altered aPTT significantly.
Del Cotillo
Mercedes
M
Hospital Mútua de Terrassa, Intensive Care Unit (ICU), Plaza Dr. Robert 5, 08221 Terrassa, Spain. mercedes7870@hotmail.com
Grané
Núria
N
Llavoré
Maria
M
Quintana
Salvador
S
D002406:Catheterization, Peripheral; D002408:Catheters, Indwelling; D016009:Chi-Square Distribution; D004311:Double-Blind Method; D005260:Female; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D010976:Platelet Count; D012965:Sodium Chloride / Q000627:therapeutic use*; D012996:Solutions; D014654:Vascular Patency
D012996:Solutions; D012965:Sodium Chloride; D006493:Heparin