title: Usefulness of intravenous heparin to prevent thrombosis of central venous catheter in children.
abstract: BACKGROUND
  central venous catheter (CVC) thrombosis in children is a main issue and its prevention with intravenous heparin is still controversial. The aim of this study was to evaluate efficacy of intravenous heparin in preventing CVC thrombosis both clinically and macroscopically.
  
  
  METHODS
  we conducted a randomized clinical trial in a tertiary care children's hospital with patients <18 years of age with CVC. Experimental group included addition of heparin at 2 IU/ml of intravenous fluids (IV), whereas the control group did not include heparin.
  
  
  RESULTS
  seventy six lumen of catheters were included, 38 in each group. Both groups were homogeneous in epidemiological variables. Macroscopic thrombus was found in 27 (35.5%) lumen of catheters. The group with heparin showed thrombus in 7.8% and 63% in the control group (p <0.0001 with relative risk (RR) of 20 and confidence interval (CI) at 95% (5.1-77.2). Clinical evaluation showed adequate flow in the IV of the heparin group in 94.7% and 57.8% in the control group (p <0.001). Blood return through the lumen of catheters with heparin was present in 86.8% and 42.1% in the control group (p <0.001). Mean time for catheters was 14.3 days. There were no side effects or prolonged partial thromboplastin time.
  
  
  CONCLUSIONS
  heparin infusion at 2 IU/ml is safe and effective in preventing CVC thrombosis in children.
authors.affiliation: Departamento de Cirugía General, Hospital Infantil de México "Federico Gómez," Secretaría de Salud, México, D. F., Mexico. eduardo@fambracho.org
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bracho-Blanchet
authors.forename: Jorge
authors.initials: J
authors.lastname: Cortés-Sauza
authors.forename: Roberto
authors.initials: R
authors.lastname: Dávila-Pérez
authors.forename: Pablo
authors.initials: P
authors.lastname: Lezama-Del Valle
authors.forename: César
authors.initials: C
authors.lastname: Villalobos-Alfaro
authors.forename: Jaime
authors.initials: J
authors.lastname: Nieto-Zermeño
mesh_terms: D000293:Adolescent; D000925:Anticoagulants / Q000008:administration & dosage*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002675:Child, Preschool; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D011446:Prospective Studies; D013927:Thrombosis / Q000209:etiology* / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D006493:Heparin