Comparison between the effects of normal saline with and without heparin for the prevention and management of arterial catheter occlusion: a triple-blinded randomized trial

J Anesth. 2021 Aug;35(4):536-542. doi: 10.1007/s00540-021-02949-1. Epub 2021 May 27.

Abstract

Purpose: We aimed to compare the effects of saline with and without heparin on the catheter-occlusion rate and coagulation-related blood test results for the management of arterial catheters among patients admitted to a short-term intensive care unit postoperatively.

Methods: This prospective, triple-blinded, randomized controlled study recruited patients aged 20-90 years scheduled to undergo radial arterial catheter insertion and postoperative intensive care unit admission between February and August 2019. Patients were randomly allocated to two groups (1:1 ratio) depending on the use of heparin: study (normal saline with heparin, 3000 units to 500 ml of normal saline) and control (normal saline without heparin) groups with arterial catheters. The allocated management method was employed immediately after intensive care unit admission. Occlusion assessment (every 12 h), arterial blood gas tests (every 6 h), and blood sample collection (every 24 h) were performed. The occlusion of arterial catheter was assessed using occlusion rate, and blood test results were assessed using a linear mixed model.

Results: There were 147 patients in the arterial catheter groups. There were no significant differences in occlusion rates and changes in platelet counts and activated partial thromboplastin time between the groups with arterial (p = 0.98, 0.16, and 0.32, respectively) catheters during the first 6 days after intensive care unit admission.

Conclusion: Normal saline with and without heparin showed similar efficiency for both the prevention of occlusion and the results of coagulation.

Keywords: Arterial catheter; Heparin; Occlusion management; Platelet count; Thrombocytopenia.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anticoagulants
  • Catheterization, Peripheral*
  • Catheters
  • Heparin
  • Humans
  • Partial Thromboplastin Time
  • Prospective Studies
  • Radial Artery
  • Saline Solution*

Substances

  • Anticoagulants
  • Saline Solution
  • Heparin