| Heparin flushing and other interventions to maintain patency of central venous catheters: a systematic review. | |
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MedLine Citation:
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PMID: 20568318 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: This paper is a report of a review to assess clinical studies comparing the effectiveness of different means of maintaining central venous catheter patency. BACKGROUND: Flushing with heparin is a routine part of central venous catheter maintenance, but it presents risks, including heparin-induced thrombocytopenia. Other techniques used to prevent occlusion of catheters include saline flushes, heparin-bonded catheters and pressure caps. DATA SOURCES: A search was conducted using the MEDLINE, CINAHL, EMBASE, Cochrane, National Guideline Clearinghouse and University Healthsystem Consortium databases. METHODS: A systematic review of effectiveness was conducted, using GRADE criteria to assess the strength of evidence for each intervention. The review period covered 1982 or earlier to January 2008. RESULTS: There is weak evidence that heparin flushing reduces occlusion of catheters, but no evidence that it reduces bloodstream infections. Results from clinical trials of pressure caps are inconsistent regarding their ability to maintain catheter patency, but provide moderate evidence that at least some varieties of caps are associated with increased bloodstream infections. CONCLUSION: The evidence base on heparin flushing and other interventions to prevent catheter occlusion is small, and published studies are of low quality. There is insufficient evidence on which to conclude that flushing catheters with heparin is more effective than flushing with saline solution. |
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Authors:
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Matthew D Mitchell; Barbara Jo Anderson; Kendal Williams; Craig A Umscheid |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Journal of advanced nursing Volume: 65 ISSN: 0309-2402 ISO Abbreviation: J Adv Nurs Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2010-06-22 Completed Date: 2010-11-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7609811 Medline TA: J Adv Nurs Country: England |
Other Details:
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Languages: eng Pagination: 2007-21 Citation Subset: IM; N |
Affiliation:
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Center for Evidence-based Practice, University of Pennsylvania Health System, Philadelphia, USA. mdmitchell@uphs.upenn.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anticoagulants / administration & dosage*, adverse effects Catheter-Related Infections / etiology, prevention & control* Catheterization, Central Venous / instrumentation* Child Child, Preschool Equipment Failure Evidence-Based Practice Heparin / administration & dosage*, adverse effects Humans Infant Infusions, Intra-Arterial* / instrumentation Nursing Research / methods Practice Guidelines as Topic Sodium Chloride / administration & dosage Thrombocytopenia / chemically induced Thrombosis / prevention & control Treatment Outcome Urokinase-Type Plasminogen Activator / administration & dosage |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants; 7647-14-5/Sodium Chloride; 9005-49-6/Heparin; EC 3.4.21.73/Urokinase-Type Plasminogen Activator |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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