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A low dose heparinized saline protocol is associated with improved duration of arterial line patency in critically

Lydia R Maurer1, Casey M Luckhurst1, Arzo Hamidi2

  • 1Department of Surgery, Massachusetts General Hospital, Boston, MA, United States of America.

Journal of Critical Care
|September 13, 2020
PubMed

Insights

A low dose heparinized saline (LDHS) protocol improved arterial line patency in critically ill COVID-19 patients. This method enhanced line duration without increasing bleeding risk, offering a safe and effective solution for thrombosis prevention.

Area of Science:

  • Critical care medicine
  • Vascular access
  • Thrombosis management

Background:

  • Critically ill patients with Coronavirus Disease 2019 (COVID-19) exhibit high rates of line thrombosis.
  • Maintaining arterial line (a-line) patency is crucial for hemodynamic monitoring in these patients.

Purpose of the Study:

  • To evaluate the safety and efficacy of a low dose heparinized saline (LDHS) arterial line patency protocol.
  • To determine if LDHS impacts a-line thrombosis rates and bleeding complications in COVID-19 patients.

Main Methods:

  • Observational cohort study comparing patients before and after implementation of an LDHS protocol (10 units/h).
  • Included adult COVID-19 patients admitted to the ICU.
  • Analyzed a-line patency duration and bleeding complications.

Main Results:

  • The LDHS protocol group showed a significantly longer median duration of a-line patency (8.5 days) compared to the pre-LDHS group (2.9 days).
  • Baseline characteristics, including age and systemic anticoagulation, were similar between groups.
  • The incidence of bleeding complications was comparable between the LDHS and pre-LDHS cohorts (10% vs. 13%).

Conclusions:

  • A low dose heparinized saline protocol significantly improves arterial line patency duration in COVID-19 patients.
  • The LDHS protocol is a safe and effective strategy, as it does not increase bleeding risk.
  • This finding supports the use of LDHS for maintaining arterial line patency in critically ill COVID-19 patients.
Abstract

Keywords:
COVID-19Critical illnessHeparinThrombosisVascular access devices

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