Impact of low-dose heparin on duration of peripherally inserted central catheter at the Neonatal Intensive Care Unit: A meta-analysis.
- Author:
Ma. Leah Pamela W. Ilagan
;
Genevieve A. Abuan
;
Sharlene S. Seng
- Publication Type:Journal Article
- Keywords:
heparin;
peripherally inserted central catheter;
patency;
neonates
- From:
The Philippine Children’s Medical Center Journal
2021;17(1):12-24
- CountryPhilippines
- Language:English
-
Abstract:
OBJECTIVES:To determine efficacy of continuous heparin infusion vs placebo on
maintenance of peripherally inserted central catheter line among neonates admitted at the NICU.
METHODS:This is a meta-analysis of randomized controlled trials reported in accordance with
PRISMA checklist. Cochrane Risk-of-bias tool was used in assessment of reporting biases.
Pooled risk ratios were estimated using random- or fixed-effects model.
RESULTS:Of 4519 studies identified, 4 studies were included, and all have low risk of bias.
Meta-analysis showed that continuous heparin infusion on PICCs had significantly higher
duration of catheter patency compared to the placebo group (MD=2.22, 95%CI=1.03-3.14, pvalue<0.00001). Heparin group also had decreased risk of occlusion (RR=0.47, 95%CI=0.94, pvalues=0.03) compared to control. The risk for other adverse events such as thrombosis,
infection, IVH progression, and mortality was comparable between the two groups.
CONCLUSION:Continuous heparin infusion in PICC fluids can prolong duration of catheter
patency by 2.2 days and reduce risk of catheter-related occlusion by 50%, without having
significant effect on incidence of other adverse events.
RECOMMENDATIONS:Continuous heparin infusion on PICC fluids should be part of
maintenance and care policy at the NICU, but precautions should be followed to prevent adverse
outcomes. Systematic review of intermittent heparin flushing can be a window of opportunity.
- Full text:Impact of low-dose heparin.pdf
