Clinical trial: Comparison of pressurized infusion saline systems with and without heparin for the maintenance of vascular access in critically ill patients.

Abstract

Aim: To evaluate the efficacy of 0.9% saline solution versus heparinized solution for maintaining the patency of intravascular catheters.

Method: Single-center, randomized, controlled, single-blind clinical trial.

Population: patients with intravascular arterial and/or central venous catheters.

Variables: age, sex, admission diagnosis, catheter type and location, duration of catheter placement, catheter functionality, reason for removal, antiplatelet treatment, Activated Partial Thromboplastin Time (APTT), and International Normalized Ratio (INR) values. Data collection was carried out using an ad hoc questionnaire. SPSS v.26 software was used for statistical analysis, including descriptive analysis (median and IQR), Mann-Whitney U test, variable association (chi-square test), and logistic regression. A p-value < 0.05 was considered the indicator of a significant difference.

Results: Data were collected from 373 patients, of whom 68,4% were male. Heparin was administered to 202 patients (54,2%) and 0.9% saline to 171 patients (45,8%). A total of 595 catheters were analyzed: 221 (37,1%) arterial catheters, 229 (38,5%) centrally inserted central venous catheters, and 145 (24,4%) peripherally inserted central venous catheters. A total of 51 complications (8,6%) were detected, with a higher incidence in the heparin group (10,4% versus 6,3%). Among all complications, significant differences were observed by catheter type, with an incidence of 11,8% in arterial catheters, compared to 7,4% in centrally inserted central venous catheters and 5,5% in peripherally inserted central venous catheters.

Conclusions: No significant differences were observed in maintaining catheter patency between systems using heparinized pressurization and those using 0.9% saline solution.