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Heparin-bonded central venous lines reduce thrombotic and infective complications in critically ill children

C M Pierce1, A Wade, Q Mok

  • 1Paediatric Intensive Care Unit, Great Ormond Street Hospital for Children, London, UK. christine.pierce@gosh-tr.nthames.nhs.uk

Intensive Care Medicine
|September 16, 2000
PubMed

Insights

Heparin-bonded (HB) central venous lines (CVLs) significantly reduce infection and thrombosis in critically ill children. This study demonstrates the effectiveness of HB CVLs in pediatric intensive care units.

Area of Science:

  • Medical research
  • Pediatric intensive care
  • Biomaterials science

Background:

  • Central venous lines (CVLs) are essential in intensive care but carry risks of thrombosis and infection.
  • Heparin bonding is a potential strategy to mitigate these risks.
  • Critically ill children are particularly vulnerable to catheter-related complications.

Purpose of the Study:

  • To evaluate the efficacy of heparin-bonded (HB) central venous lines (CVLs) in reducing catheter-related thrombosis and infection.
  • To compare outcomes between HB CVLs and non-heparin-bonded (NHB) CVLs in a pediatric intensive care setting.

Main Methods:

  • Prospective, double-blind, randomized controlled study in a tertiary pediatric intensive care unit.
  • 209 critically ill children (0-16 years) requiring a CVL were randomized to receive either HB or NHB CVLs.
  • Infection and thrombosis rates were monitored through blood cultures, ultrasound, and line cultures.

Main Results:

  • Heparin bonding was associated with a significant reduction in infections (4% vs. 33%) and thrombosis (0% vs. 8%).
  • The hazard ratio for infection with HB CVLs was 0.11 (P < 0.00005).
  • The number needed to treat for HB CVLs to prevent one episode of infection or thrombosis was 3 and 13, respectively.

Conclusions:

  • Heparin-bonded central venous lines significantly decrease the incidence of both infection and thrombosis in critically ill children.
  • The use of HB CVLs is a valuable intervention for improving safety in pediatric intensive care.
  • This study provides strong evidence supporting the routine use of HB CVLs in this patient population.
Abstract

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