Intermittent heparin is not effective at preventing the occlusion of peripherally inserted central venous catheters in preterm and term neonates.
OBJECTIVE
To evaluate the effectiveness of intermittent 10 U/mL heparin flushes in reducing the occlusion of peripherally inserted central catheters in neonates.


METHODS
In this randomized, open-label, prospective, controlled study, neonates were allocated either to receive 0.5 mL flushes of heparin (Group 1: n = 64) or saline (Group 2: n = 69) every 4 hours. Actions were taken to restore patency by using negative pressure (3-way stopcock method) in cases of occlusion.


RESULTS
A total of 133 neonates were included. No significant intergroup difference was observed in the number of new occlusions (26 in Group 1, or 31/1,000 catheter-days; 36 in Group 2, or 36/1,000 catheter-days; P = 0.19). In Group 1, 5 catheters had 9 recurrent obstructions after successful clearance maneuvers. In Group 2, 19 catheters had 40 relapses (P < 0.0001), showing heparin's protective role against recurrence of obstruction (Relative Risk = 0.36). However, heparin failed to prevent catheter withdrawal due to permanent occlusion (3 catheters in Group 1 and 8 in Group 2; P = 0.24).


CONCLUSIONS
Intermittent heparin is not effective for preventing the occlusion of peripherally inserted central catheters in neonates but reduces relapses when clearance maneuvers were successful.
Orlei Ribeiro de
OR
Araujo
Milena Corrêa
MC
Araujo
Jane Sousa E
JS
Silva
Marcella Mathias de
MM
Barros