Heparin flush vs. normal saline flush to maintain the patency of central venous catheter among adult patients: A systematic review and meta-analysis
Background: Around the globe, protocols for flushing the catheter to maintain the patency of central venous catheter (CVC) vary by institution to institution or by practitioner to practitioner. Therefore, this review was carried out with the aim of evaluating the efficacy of heparin flush vs. normal...
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Wolters Kluwer Medknow Publications
2019-01-01
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doaj-eaa7d15e5b2048dcb6d3e978c9ce30552020-11-24T21:20:55ZengWolters Kluwer Medknow PublicationsJournal of Family Medicine and Primary Care2249-48632019-01-01892779279210.4103/jfmpc.jfmpc_669_19Heparin flush vs. normal saline flush to maintain the patency of central venous catheter among adult patients: A systematic review and meta-analysisSuresh K SharmaShiv K MudgalRakhi GaurRakesh SharmaManeesh SharmaKalpana ThakurBackground: Around the globe, protocols for flushing the catheter to maintain the patency of central venous catheter (CVC) vary by institution to institution or by practitioner to practitioner. Therefore, this review was carried out with the aim of evaluating the efficacy of heparin flush vs. normal saline flush to maintain the patency of CVC among adult patients. Methods: We followed the guidelines of Cochrane handbook for interventions and searched in MEDLINE, Embase, Cochrane library, Clinical trials database, and reference list of related articles, which were published from Jan. 2012 to 31 Dec. 2018 in English language. We included only randomized controlled trials, and nine studies were included in this review. The pooled standard mean difference and relative risk were calculated by using Rev Man Review Manager 5. Results: We identified nine eligible studies with a total number of 3,113 participants. Consolidated results from eight studies conveyed little favorable effect to maintain patency of CVC with heparin when compared with normal saline as evident by risk ratio 0.83, 95% CI 0.50 – 1.40; P = 0.13. We also carried out analysis for secondary outcomes, and there was no evidence that heparin was better than normal saline in terms of safety except heparin-induced thrombocytopenia. Conclusions: Heparin has little favorable effects to maintain patency of catheter than normal saline but not in secondary outcomes. As the quality of evidence was very low, therefore, results should be comprehend with care.http://www.jfmpc.com/article.asp?issn=2249-4863;year=2019;volume=8;issue=9;spage=2779;epage=2792;aulast=SharmaCentral venous catheterheparinnormal salinepatency |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Suresh K Sharma Shiv K Mudgal Rakhi Gaur Rakesh Sharma Maneesh Sharma Kalpana Thakur |
spellingShingle |
Suresh K Sharma Shiv K Mudgal Rakhi Gaur Rakesh Sharma Maneesh Sharma Kalpana Thakur Heparin flush vs. normal saline flush to maintain the patency of central venous catheter among adult patients: A systematic review and meta-analysis Journal of Family Medicine and Primary Care Central venous catheter heparin normal saline patency |
author_facet |
Suresh K Sharma Shiv K Mudgal Rakhi Gaur Rakesh Sharma Maneesh Sharma Kalpana Thakur |
author_sort |
Suresh K Sharma |
title |
Heparin flush vs. normal saline flush to maintain the patency of central venous catheter among adult patients: A systematic review and meta-analysis |
title_short |
Heparin flush vs. normal saline flush to maintain the patency of central venous catheter among adult patients: A systematic review and meta-analysis |
title_full |
Heparin flush vs. normal saline flush to maintain the patency of central venous catheter among adult patients: A systematic review and meta-analysis |
title_fullStr |
Heparin flush vs. normal saline flush to maintain the patency of central venous catheter among adult patients: A systematic review and meta-analysis |
title_full_unstemmed |
Heparin flush vs. normal saline flush to maintain the patency of central venous catheter among adult patients: A systematic review and meta-analysis |
title_sort |
heparin flush vs. normal saline flush to maintain the patency of central venous catheter among adult patients: a systematic review and meta-analysis |
publisher |
Wolters Kluwer Medknow Publications |
series |
Journal of Family Medicine and Primary Care |
issn |
2249-4863 |
publishDate |
2019-01-01 |
description |
Background: Around the globe, protocols for flushing the catheter to maintain the patency of central venous catheter (CVC) vary by institution to institution or by practitioner to practitioner. Therefore, this review was carried out with the aim of evaluating the efficacy of heparin flush vs. normal saline flush to maintain the patency of CVC among adult patients. Methods: We followed the guidelines of Cochrane handbook for interventions and searched in MEDLINE, Embase, Cochrane library, Clinical trials database, and reference list of related articles, which were published from Jan. 2012 to 31 Dec. 2018 in English language. We included only randomized controlled trials, and nine studies were included in this review. The pooled standard mean difference and relative risk were calculated by using Rev Man Review Manager 5. Results: We identified nine eligible studies with a total number of 3,113 participants. Consolidated results from eight studies conveyed little favorable effect to maintain patency of CVC with heparin when compared with normal saline as evident by risk ratio 0.83, 95% CI 0.50 – 1.40; P = 0.13. We also carried out analysis for secondary outcomes, and there was no evidence that heparin was better than normal saline in terms of safety except heparin-induced thrombocytopenia. Conclusions: Heparin has little favorable effects to maintain patency of catheter than normal saline but not in secondary outcomes. As the quality of evidence was very low, therefore, results should be comprehend with care. |
topic |
Central venous catheter heparin normal saline patency |
url |
http://www.jfmpc.com/article.asp?issn=2249-4863;year=2019;volume=8;issue=9;spage=2779;epage=2792;aulast=Sharma |
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