Does low-dose heparin maintain central venous access device patency?: a comparison of heparin versus saline during a period of heparin shortage

JPEN. Journal of Parenteral and Enteral Nutrition
Mark A JonkerKenneth A Kudsk

Abstract

A common problem that complicates use of central venous access devices (CVADs) is occlusion by thrombosis. Alteplase, a recombinant tissue plasminogen activator, is used to restore line patency when thrombosis occurs. Heparin flush is commonly used to prevent this complication, but the effectiveness of this practice is unclear. A recent heparin shortage allowed examination of heparin effectiveness in reducing CVAD thrombosis. A retrospective cohort study was performed by querying a pharmacy database for alteplase use for CVAD thrombosis in adult patients during periods when heparin flushes (10 units/mL) were used and when saline flushes were used instead because of a nationwide heparin shortage. The number of patients receiving alteplase, the number of doses administered, and the total amount of alteplase used were compared over 1-month intervals of heparin flush use and 1-month intervals of saline flush use. Patient days and critical care patient days were compared between these time intervals. Peripherally inserted central catheter (PICC) line placements and replacements between time periods of heparin and saline flush were also compared. Significant increases in the number of patients receiving alteplase (P = .04), the numbe...Continue Reading

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Citations

Aug 28, 2015·Journal of the American Geriatrics Society·Vineet ChopraLona Mody
Jul 5, 2015·Revista paulista de pediatria : orgão oficial da Sociedade de Pediatria de São Paulo·Mavilde Luz Gonçalves Pedreira
Mar 16, 2017·Journal of Vascular and Interventional Radiology : JVIR·Shawna N SmithVineet Chopra
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Jul 31, 2018·The Cochrane Database of Systematic Reviews·Eduardo López-BrizAmanda Burls
Jul 2, 2014·Journal of Infusion Nursing : the Official Publication of the Infusion Nurses Society·Margaret G Lyons, Ann G Phalen
Apr 11, 2012·Critical Care Medicine·Marilyn E SchallomLee P Skrupky

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