Heparin in peripherally inserted central catheters did not alter elective removal and complication rates in preterm infants

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-03-18 DOI:10.1016/j.clnesp.2025.03.024

Dirk Wackernagel , Vanessa Gavelli , Per Nydert

{"title":"Heparin in peripherally inserted central catheters did not alter elective removal and complication rates in preterm infants","authors":"Dirk Wackernagel , Vanessa Gavelli , Per Nydert","doi":"10.1016/j.clnesp.2025.03.024","DOIUrl":null,"url":null,"abstract":"<div><h3>Background & aims</h3><div>In preterm and sick newborn infants, peripherally inserted central catheters (PICC) are used for the delivery of concentrated parenteral nutrition and other high risk drugs. Despite the precaution issued by the ESPGHAN 2018, heparin is used in many neonatal intensive care units (NICU) and is thought to extend PICC usability. This study aimed to examine the association of prophylactic heparin with elective PICC removal rates, with complication rates and dwell-times.</div></div><div><h3>Methods</h3><div>All PICCs placed at two different Level III NICUs during 2017, were analyzed retrospectively. Out of 168 PICCs, 36 had to be excluded, leaving 132 PICCs for analysis. Prophylactic heparin was used in 90 PICCs (heparin-group) and 42 PICCs without (control group)</div></div><div><h3>Results</h3><div>Sixty-six PICCs (73 %) vs 30 (71 %) could be removed electively in the heparin-group (adjusted Odds Ratio 95 % confidence interval (CI) 0.95 [0.31, 2.89], p > 0.9). Complications occurred in 17 (19 %) and 8 (19 %) PICCs in the heparin-group and control-group, respectively. Dwell-times did not differ significantly with median 10 days (Interquartile range (IQR) 6,17) in the heparin-group and 8 days (IQR 7,12) in the control-group with an adjusted hazard ratio 0.70 (95 % CI [0.45, 1.09], p = 0.11).</div></div><div><h3>Conclusion</h3><div>In our retrospective analysis, adding heparin to admixtures infused via PICCs did not alter the odds of elective removals or complication rates. Furthermore, Dwell-times did not differ significantly between the two groups. In line with the ESPGHAN recommendations, our data can not support the use of heparin to improve PICC usability.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"67 ","pages":"Pages 200-205"},"PeriodicalIF":2.9000,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical nutrition ESPEN","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2405457725001159","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background & aims

In preterm and sick newborn infants, peripherally inserted central catheters (PICC) are used for the delivery of concentrated parenteral nutrition and other high risk drugs. Despite the precaution issued by the ESPGHAN 2018, heparin is used in many neonatal intensive care units (NICU) and is thought to extend PICC usability. This study aimed to examine the association of prophylactic heparin with elective PICC removal rates, with complication rates and dwell-times.

Methods

All PICCs placed at two different Level III NICUs during 2017, were analyzed retrospectively. Out of 168 PICCs, 36 had to be excluded, leaving 132 PICCs for analysis. Prophylactic heparin was used in 90 PICCs (heparin-group) and 42 PICCs without (control group)

Results

Sixty-six PICCs (73 %) vs 30 (71 %) could be removed electively in the heparin-group (adjusted Odds Ratio 95 % confidence interval (CI) 0.95 [0.31, 2.89], p > 0.9). Complications occurred in 17 (19 %) and 8 (19 %) PICCs in the heparin-group and control-group, respectively. Dwell-times did not differ significantly with median 10 days (Interquartile range (IQR) 6,17) in the heparin-group and 8 days (IQR 7,12) in the control-group with an adjusted hazard ratio 0.70 (95 % CI [0.45, 1.09], p = 0.11).

Conclusion

In our retrospective analysis, adding heparin to admixtures infused via PICCs did not alter the odds of elective removals or complication rates. Furthermore, Dwell-times did not differ significantly between the two groups. In line with the ESPGHAN recommendations, our data can not support the use of heparin to improve PICC usability.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.