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Comparison between Saline Solution Containing Heparin versus Saline Solution in the Lock of Totally Implantable
Antonio Rafael de Oliveira Brito1, Kenji Nishinari2, Paulo Fernandes Saad3
1Department of Vascular and Endovascular Surgery, San Francisco Valley University Hospital, Petrolina, Pernambuco, Brazil.
Insights
Comparing heparin (Hep group) and saline solution (SS group) locks for totally implantable catheters, this study found no significant differences in occlusion, reflux, or flow dysfunction. The research included 862 patients, making it the largest analysis of its kind.
Area of Science:
- Medical devices
- Oncology
- Vascular access
Background:
- Limited comparative studies exist on totally implantable catheter lock solutions.
- This study is the largest to date, analyzing 862 patients.
- It uniquely assesses occlusion, reflux, and flow dysfunction.
Purpose of the Study:
- To compare the efficacy of heparin versus saline solution as catheter locks.
- To evaluate the impact of lock solutions on catheter dysfunction.
Main Methods:
- Retrospective analysis of 862 patients from 2007-2015 at an oncology center.
- Patients were divided into two groups: Hep group (saline with heparin) and SS group (saline only).
- Catheter dysfunction parameters (occlusion, reflux, flow) were analyzed.
Main Results:
- Hep group: 270 patients; SS group: 592 patients.
- Occlusion: 2.96% (Hep) vs. 1.35% (SS), P=0.11.
- Reflux dysfunction: 2.96% (Hep) vs. 1.35% (SS), P=0.11.
- Flow dysfunction: 0.37% (Hep) vs. 0.68% (SS), P=1.
Conclusions:
- No statistically significant difference in occlusion between heparin and saline locks.
- No significant difference in reflux dysfunction between the two lock solutions.
- Heparin and saline locks demonstrated comparable safety and efficacy regarding catheter dysfunction.
Background:
There are only 3 studies comparing the efficacy of 2 different types of lock used in totally implantable catheters regarding occlusion or reflux dysfunction. The present study contains the largest published casuistry (862 patients) and is the only one that analyzes 3 parameters: occlusion, reflux dysfunction, and flow dysfunction.
Methods:
This was a retrospective study of patients operated at a large oncology center and followed up in the outpatient clinic between 2007 and 2015. The patients were divided into 2 groups according to the type of lock: the Hep group (heparine), whose lock was composed of saline solution 0.9% with heparin (100 IU/mL) and the SS group (saline solution), whose lock was composed of saline solution 0.9%.
Results:
The Hep group was composed of 270 patients (31%) and the SS group of 592 patients (69%). Regarding occlusion, there were 8 cases in the Hep group (2.96%) and 8 in the SS group (1.35%; P = 0.11); in relation to reflux dysfunction, there were 8 cases in the Hep group (2.96%) and 8 in the SS group (1.35%; P = 0.11); in relation to flow dysfunction, there was 1 case in the Hep group (0.37%) and 4 cases in the SS group (0.68%; P = 1).
Conclusions:
There was no statistically significant difference between the groups regarding occlusion, reflux dysfunction, and flow dysfunction.
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