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0.9% sodium chloride injection with and without heparin for maintaining peripheral indwelling intermittent-infusion
1Pharmacy Department, Children's Hospital of Wisconsin, Milwaukee, WI 53201, USA.
Insights
For infants, using 0.9% sodium chloride injection with or without heparin sodium to maintain peripheral indwelling intermittent-infusion devices (PIIIDs) showed no significant difference in effectiveness or complications. Both methods proved equally safe and reliable for PIIID maintenance in neonates.
Area of Science:
- Pediatric critical care
- Intravenous therapy
- Pharmacology
Background:
- Peripheral indwelling intermittent-infusion devices (PIIIDs) are crucial for administering medications to infants.
- Maintaining PIIID patency is essential to avoid complications and ensure timely drug delivery.
- Heparinized saline is often used to maintain PIIID patency, but its efficacy and safety in infants require further investigation.
Purpose of the Study:
- To compare the efficacy and safety of 0.9% sodium chloride injection with and without heparin sodium for maintaining PIIIDs in infants.
- To evaluate differences in PIIID dwell time, reasons for removal, and medication-related irritation between the two groups.
Main Methods:
- A double-blind, randomized study involving infants under one year of age with a 24-gauge PIIID.
- Patients were assigned to receive either 0.9% sodium chloride injection or 0.9% sodium chloride injection with heparin sodium (10 units/mL) for capping the PIIID.
- PIIIDs were capped every eight hours or after each medication administration.
Main Results:
- No significant differences were observed between the heparinized and non-heparinized saline groups in PIIID dwell time, reasons for removal, or number of cappings.
- The irritant potential of administered drugs and the severity of medication-related irritation were comparable between the two groups.
- The study found no significant difference in maintaining 24-gauge PIIIDs in children younger than one year using either solution.
Conclusions:
- 0.9% sodium chloride injection alone is as effective and safe as heparinized saline for maintaining PIIIDs in infants.
- The addition of heparin sodium does not offer significant benefits for PIIID maintenance in this population.
- These findings suggest that non-heparinized saline can be used for PIIID maintenance in infants, potentially simplifying care and reducing costs.
Abstract:
The use of 0.9% sodium chloride injection with and without heparin sodium for maintaining peripheral indwelling intermittent-infusion devices (PIIIDs) in infants was studied. In this double-blind study, children up to one year of age who had a 24-gauge PIIID through which a continuous i.v. infusion was no longer running were randomly assigned to have their PIIID capped with 0.9% sodium chloride injection with or without heparin sodium 10 units/mL. PIIIDs were capped every eight hours if no medications were administered; otherwise, they were capped after each dose of an i.v. drug. The heparin group had 26 patients with 28 evaluable PIIIDs, and the 0.9% sodium chloride injection group had 32 patients with 46 evaluable PIIIDs. The two groups did not differ significantly in variables assessing the duration of PIIID use, reasons for removal of PIIIDs, mean number of cappings, irritant potential of administered drugs, or severity of medication-related irritation. There was no significant difference between 0.9% sodium chloride injection with and without heparin sodium 10 units/mL in maintaining 24-gauge PIIIDs in children younger than one year.