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A randomized controlled trial for maintaining peripheral intravenous lock in children

Esther Mok1, Tany K Y Kwong, Moon Fai Chan

  • 1School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong. hsemok@inet.polyu.edu.hk

International Journal of Nursing Practice
|January 25, 2007
PubMed

Insights

For maintaining peripheral intravenous locks in children, this study found no significant differences in catheter longevity or complications among normal saline, 1 unit/ml heparin saline, and 10 units/ml heparin saline flush solutions. The 1 unit/ml heparin group showed a higher survival rate.

Area of Science:

  • Pediatric Nursing
  • Intravenous Therapy
  • Clinical Practice Research

Background:

  • Maintaining peripheral intravenous (IV) access in children is crucial.
  • Previous studies on IV flush solutions (saline vs. heparin) in pediatric populations yielded conflicting results.
  • Optimal flush solution for pediatric peripheral IV locks remains an open clinical question.

Purpose of the Study:

  • To compare the effectiveness and safety of normal saline, 1 unit/ml heparin saline, and 10 units/ml heparin saline for maintaining pediatric peripheral IV locks.
  • To establish evidence-based practice for IV flush solutions in a hospital setting.

Main Methods:

  • Prospective, randomized controlled, double-blind trial involving 123 children aged 1-10 years.
  • Participants received one of three flush solutions: normal saline, 1 unit/ml heparin saline, or 10 units/ml heparin saline.
  • Evaluated outcomes included catheter dwell time, survival rate, and incidence of IV complications.

Main Results:

  • No statistically significant differences were observed in catheter use duration, survival rates, or IV complication incidence among the three groups.
  • The 1 unit/ml heparin saline group exhibited the highest survival rate, with a mean catheter use of 49.8 hours compared to 32.5 hours for normal saline.
  • Despite a trend, overall catheter longevity and complication rates did not significantly differ between the flushing solutions.

Conclusions:

  • Normal saline, 1 unit/ml heparin saline, and 10 units/ml heparin saline are comparable for maintaining pediatric peripheral IV locks regarding longevity and complications.
  • A trend towards improved catheter survival was noted with 1 unit/ml heparin saline.
  • Further research may be needed to clarify potential benefits of low-dose heparin flushes.

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