title: [Effectiveness of heparin versus 0.9% saline solution in maintaining the permeability of central venous catheters: a systematic review].
abstract: OBJECTIVE
  Determining which is the most effective solution (heparin flush compared to 0.9% saline flush) for reducing the risk of occlusions in central venous catheters (CVC) in adults.
  
  
  METHODS
  The systematic review followed the principles proposed by the Cochrane Handbook; critical analysis, extraction and synthesis of data were performed by two independent researchers; statistical analysis was performed using the RevMan program 5.2.8.
  
  
  RESULTS
  Eight randomized controlled trials and one cohort study were included and the results of the meta-analysis showed no difference (RR=0.68, 95% CI=0.41-1.10; p=0.12). Analysis by subgroups showed that there was no difference in fully deployed CVC (RR=1.09, CI 95%=0.53-2.22; p=0.82); Multi-Lumen CVC showed beneficial effects in the heparin group (RR=0.53, CI 95%=0.29-0.95; p=0.03); in Double-Lumen CVC for hemodialysis (RR=1.18, CI 95%=0.08-17.82; p=0.90) and Peripherally inserted CVC (RR=0.14, CI 95%=0.01-2.60; p=0.19) also showed no difference.
  
  
  CONCLUSIONS
  Saline solution is sufficient for maintaining patency of the central venous catheter, preventing the risks associated with heparin administration.
authors.affiliation: Escola Superior de Enfermagem de Coimbra, Unidade de Investigação em Ciências da Saúde, Coimbra, Portugal.
authors.forename: Eduardo José Ferreira Dos
authors.initials: EJ
authors.lastname: Santos
authors.affiliation: Instituto Politécnico de Viseu, Centro de Estudos em Educação, Tecnologias e Saúde, Viseu, Portugal.
authors.forename: Maria Madalena Jesus Cunha
authors.initials: MM
authors.lastname: Nunes
authors.affiliation: Escola Superior de Enfermagem de Coimbra, Unidade de Investigação em Ciências da Saúde, Coimbra, Portugal.
authors.forename: Daniela Filipa Batista
authors.initials: DF
authors.lastname: Cardoso
authors.affiliation: Escola Superior de Enfermagem de Coimbra, Unidade de Investigação em Ciências da Saúde, Coimbra, Portugal.
authors.forename: João Luís Alves
authors.initials: JL
authors.lastname: Apóstolo
authors.affiliation: Escola Superior de Enfermagem de Coimbra, Unidade de Investigação em Ciências da Saúde, Coimbra, Portugal.
authors.forename: Paulo Joaquim Pina
authors.initials: PJ
authors.lastname: Queirós
authors.affiliation: Escola Superior de Enfermagem de Coimbra, Unidade de Investigação em Ciências da Saúde, Coimbra, Portugal.
authors.forename: Manuel Alves
authors.initials: MA
authors.lastname: Rodrigues
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage*; D061807:Catheter Obstruction; D062905:Central Venous Catheters; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D012965:Sodium Chloride / Q000008:administration & dosage*
chemical_list: D000925:Anticoagulants; D012965:Sodium Chloride; D006493:Heparin