Heparin or saline for flushing CVADs?
A Cochrane review 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, these findings challenge its continued use in CVC flushing outside the context of clinical trials.
Heparin or saline for flushing pediatric CVADs?
Another Cochrane review found that there was not enough evidence to determine the effects of intermittent flushing of heparin versus normal saline to prevent occlusion in long term central venous catheters in infants and children. Ultimately, if this evidence were available, the development of evidenced-based clinical practice guidelines and consistency of practice would be facilitated.
Bradford NK, Edwards RM, Chan RJ. Heparin versus 0.9% sodium chloride intermittent flushing for the prevention of occlusion in long term central venous catheters in infants and children. Cochrane Database of Systematic Reviews 2015, Issue 11. Art. No.: CD010996. DOI: 10.1002/14651858.CD010996.pub2 http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010996.pub2/epdf
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