Alliance for Vascular Access Teaching And Research

Evidence Summaries- Flushing

López-Briz E, Ruiz Garcia V, Cabello JB, Bort-Marti S, Carbonell Sanchis R, Burls A. Heparin versus 0.9% sodium chloride intermittent flushing for prevention of occlusion in central venous catheters in adults. Cochrane Database of Systematic Reviews 2014, Issue 10. Art. No.: CD008462. DOI: 10.1002/14651858.CD008462.pub2.

http://www.ncbi.nlm.nih.gov/pubmed/25300172

Authors' conclusions
We found no conclusive evidence of important differences when heparin intermittent flushing was compared with 0.9% normal saline flushing for central venous catheter maintenance in terms of efficacy or safety. As heparin is more expensive than normal saline, our findings challenge its continued use in CVC flushing outside the context of clinical trials.


Robertson-Malt S, Malt GN, Farquhar V, Greer W. Heparin versus normal saline for patency of arterial lines. Cochrane Database of Systematic Reviews 2014, Issue 5. Art. No.: CD007364. DOI: 10.1002/14651858.CD007364.pub2.

http://www.ncbi.nlm.nih.gov/pubmed/24825673

Authors' conclusions
The available evidence is of poor quality because of risk of bias and does not provide sufficient information to support the effects of adding heparin (1 to 2 IU/mL) to a maintenance solution (pressurized to deliver 3 mL of flush solution per hour) of 0.9% normal saline in maintaining the patency and functionality of arterial catheters.

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