Dose-dependent effects of heparin sodium injection in preventing peripherally inserted central catheter-related venous thrombosis during postoperative chemotherapy in non-small cell lung carcinoma patients.

Abstract

Objective: To evaluate the preventive effects of varying doses of heparin sodium injection on peripherally inserted central catheter (PICC)-related venous thrombosis during postoperative chemotherapy in patients with non-small cell lung carcinoma (NSCLC), and to analyze potential risk factors for the occurrence of venous thrombosis.

Methods: This study was a single-center, single-blind, randomized controlled trial involving 425 NSCLC patients who underwent PICC placement at the Cancer Hospital Chinese Academy of Medical Sciences, Shenzhen Hospital from July 2019 to July 2021. All patients received chemotherapy regimens of pemetrexed plus cisplatin or paclitaxel plus cisplatin. The patients were randomly divided into three groups: the control group (using 10 mL of 0.9% saline for catheter sealing), Group I (using 2 mL of 10 IU/mL heparin sodium injection for catheter sealing), and Group II (using 5 mL of 10 IU/mL heparin sodium injection for catheter sealing). The baseline characteristics of the three groups were compared using statistical methods, and Doppler ultrasound was performed on the 7th day after catheter placement to assess the occurrence of venous thrombosis. Further correlation analysis and multivariate logistic regression analysis were conducted to explore the risk factors for thrombosis.

Results: The incidence rates of thrombosis in the three groups were 20.00% in the control group, 7.75% in Group I, and 2.10% in Group II, with statistically significant differences among the groups (P < 0.001). Additionally, correlation analysis of baseline characteristics and thrombosis occurrence revealed a significant association between different doses of heparin sodium injection and thrombosis (P < 0.001), while other baseline characteristics (such as age, sex, and weight) showed no significant differences in relation to thrombosis (P > 0.05). Multivariate logistic regression analysis indicated that heparin sodium injection was a protective factor against thrombosis, with Group I: OR = 0.312 (P = 0.003) and Group II: OR = 0.081 (P < 0.001), suggesting that the preventive effect was more pronounced in Group II. Safety evaluation did not reveal any severe adverse reactions.

Conclusion: This study demonstrates that the use of heparin sodium injection is associated with a reduced incidence of PICC-related venous thrombosis in NSCLC patients during postoperative chemotherapy. At appropriate doses, heparin sodium injection exhibits favorable safety and may provide a potential clinical option for PICC patients at high risk of thrombosis.