A randomized controlled trial for maintaining peripheral intravenous lock in children

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.