Heparin Flushing And Dripping To Maintain Patency Of Peripherally Inserted Central Catheters:a Systematic Review

ObjectiveThe primary objective of this review was to evaluate the effectiveness of heparin in maintaining patency of peripherally inserted central catheters and give the best practice to clinic.Secondary objective were to determine the effect of heparin on:1. The occlusion of catheters by heparin flushing in adult;2. The occlusion and thrombus of catheters by heparin dripping in neonate.MethodsWe searched the Cochrane Database of Systematic Review, JBI Database of Systematic Review, MEDLINE(1966-Jun2011), EMbase(1989-Jun2011), CINAHL(Cumulative Index to Nursing and Allied Health literature)(1982-Jun2011), CBMdisc(1978-Jun2011), and CNKI(1994-Jun2011) to collect randomized control trials(RCTs). Moreover, we searched referenced papers and professional websites (National Guideline Clearinghouse, NGC; Infusion Nurses Society, INS, http://www.insl.org).The quality of RCTs was critically appraised and data were extracted by3reviewers independently. Meta-analysis was conducted for the eligible RCTs.ResultsTen RCTs were included. Heparin dripping and flushing were reported to prevent occlusion and maintain patency of PICC. Four RCTs were heparin flushing in adult proved no significant effect of prevent occlusion. Six RCTs indicated that heparin dripping in neonate demonstrated its effect on reduce occlusion and maintain patency. Two RCTs were heparin dripping independently and four RCTs were continuous heparin into TPN.ConclusionHeparin dripping through peripherally inserted central catheters has positive effect in reducing occlusion for neonate. The functions of heparin flushing need further research.