title: Heparin Saline Versus Normal Saline for Flushing and Locking Peripheral Venous Catheters in Decompensated Liver Cirrhosis Patients: A Randomized Controlled Trial.
abstract: A prospective randomized, controlled, single-blinded trial to compare the effectiveness and safety of heparin saline (HS) to those of normal saline (NS) as flushing and locking solutions for peripheral venous catheter (PVC) in decompensated liver cirrhosis (DLC) patients.Patients with DLC at our institution between April 2012 and March 2013 were enrolled after obtaining informed consent. The patients were randomly allocated into 2 groups: the NS group received preservative-free 0.9% sodium chloride as the flushing and locking solution, while the HS group received HS (50 U/mL). PVC-related events and the duration of PVC maintenance were compared between the 2 groups. Moreover, the preinfusion and postinfusion levels of prothrombin time (PT), activated partial thromboplastin time (APTT), and platelet (PLT) were also compared.A total of 32 and 36 DLC patients in the NS (125 PVCs) and HS (65 PVCs) groups, respectively, were analyzed. Baseline characteristics, including gender, age, Child-Pugh grade, PVC type and administration of anticoagulant, and irritant agents, were comparable between the 2 groups (P > 0.05). The maintenance times of the HS and NS groups were 80.27 ± 26.47 and 84.19 ± 29.32 hours, respectively (P = 0.397). Removal of PVC for abnormal reasons occurred in 30.7% and 22.4% of patients in the HS and NS groups (P = 0.208). The PVC occlusion rates were 6.2% and 5.6% in the HS and NS groups, respectively (OR = 1.11, 95% CI 0.31-3.92). The PT, APTT, and PLT levels were comparable between the 2 groups both before and after infusion (P > 0.05). Incremental analyses showed that Child-Pugh grade C might be a risk factor for the suppression of PLT in the HS group.We consider NS to be as effective as and safer than conventional HS for flushing and locking PVC in decompensated liver cirrhosis patients.
authors.affiliation: From the Department of Gastroenterology (RW, OL, LH, MZ, LT, Z-XZ, M-GZ, HW); Infusion Nursing IV Team, West China Hospital, Sichuan University, Chengdu, China (RW, Y-LL); Faculty of Medicine, West China School of Medicine (Y-JT); Department of Hepatic Surgery (Y-LL); Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China (X-ZC).
authors.forename: Rui
authors.initials: R
authors.lastname: Wang
authors.forename: Ming-Guang
authors.initials: MG
authors.lastname: Zhang
authors.forename: Ou
authors.initials: O
authors.lastname: Luo
authors.forename: Liu
authors.initials: L
authors.lastname: He
authors.forename: Jia-Xin
authors.initials: JX
authors.lastname: Li
authors.forename: Yun-Jing
authors.initials: YJ
authors.lastname: Tang
authors.forename: Yan-Li
authors.initials: YL
authors.lastname: Luo
authors.forename: Min
authors.initials: M
authors.lastname: Zhou
authors.forename: Li
authors.initials: L
authors.lastname: Tang
authors.forename: Zong-Xia
authors.initials: ZX
authors.lastname: Zhang
authors.forename: Hao
authors.initials: H
authors.lastname: Wu
authors.forename: Xin-Zu
authors.initials: XZ
authors.lastname: Chen
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000517:prevention & control*; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D011446:Prospective Studies; D011517:Prothrombin Time; D016037:Single-Blind Method; D012965:Sodium Chloride / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D012965:Sodium Chloride; D006493:Heparin