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Heparin Versus Saline: A Comparative Study to Support Practice Change Within an Organization.

Linda Denke^1,2, Meredith Allen^1,2, Folefac Atem^1,2

¹Author Affiliations : Southwestern Medical Center, Dallas, Texas.

Journal of Infusion Nursing : the Official Publication of the Infusion Nurses Society

|January 6, 2025

Summary

0.9% sodium chloride is as effective as heparin for maintaining peripherally inserted central catheter (PICC) patency in blood cancer patients. This saline solution offers improved safety and lower costs compared to heparin for PICC line care.

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Area of Science:

Oncology Nursing
Vascular Access Devices
Pharmacology

Background:

Peripherally inserted central catheters (PICCs) are crucial for blood cancer patients.
Maintaining PICC patency is essential for treatment delivery and patient safety.
Current practices often involve heparin or saline for catheter locking.

Purpose of the Study:

To compare the effectiveness of heparin versus 0.9% sodium chloride for locking PICCs in patients with blood cancer.
To evaluate differences in catheter patency, side effects, costs, and nursing time.

Main Methods:

A nurse-led randomized study.
Patients with blood cancer received either heparin or 0.9% sodium chloride for PICC locking.
Catheter patency was assessed over a period of up to 7 days.

Main Results:

No significant difference in PICC patency was observed between heparin and 0.9% sodium chloride locking.
Heparin use was linked to increased side effects, higher costs, and greater nursing time.
0.9% sodium chloride demonstrated comparable efficacy with fewer adverse events and resource utilization.

Conclusions:

0.9% sodium chloride is a safe and cost-effective alternative to heparin for maintaining PICC patency in blood cancer patients.
Adopting 0.9% sodium chloride can enhance patient safety and reduce healthcare expenses.
This evidence supports a shift in clinical practice towards saline for PICC maintenance.