Heparin or Sodium Chloride for Prolonging Peripheral Intravenous Catheter Use in Children - A Systematic Review

Area of Science:

• Pediatric Nursing
• Medical Device Management
• Evidence-Based Practice

Background:

• Children often experience pain during hospital stays, particularly from procedures like peripheral venous catheter insertion.
• Maintaining catheter patency is crucial to avoid frequent replacements and discomfort.
• Heparin and sodium chloride are commonly used for intermittent catheter flushing.

Purpose of the Study:

• To evaluate the scientific evidence comparing the efficacy of heparin versus sodium chloride for intermittent flushing of peripheral venous catheters in children.
• To determine if heparin offers a significant advantage in extending catheter dwell time compared to sodium chloride.

Main Methods:

• A systematic review adhering to PICO guidelines was conducted.
• Databases searched included PubMed, CINAHL, and Cochrane Library.
• Included studies were systematic reviews and randomized controlled double-blinded trials, critically appraised and synthesized.

Main Results:

• Two high-quality systematic reviews and four moderate-quality randomized controlled trials were analyzed.
• Results indicated both statistically significant differences and no significant differences between heparin and sodium chloride groups regarding catheter in situ time.
• The overall evidence did not consistently favor heparin for extending catheter dwell time.

Conclusions:

• Heparin may not be essential for maintaining peripheral venous catheter patency in children.
• Current evidence is insufficient to develop clinical guidelines regarding heparin use.
• More research is required to provide evidence-based recommendations, considering heparin's potential adverse effects in pediatric patients.