1347 CONTINUOUS VERSUS INTERMITTENT HEPATIZATION OF UMBILICAL ARTERY CATHETERS

Abstract

Previous studies have compared the rate of occlusion of umbilical artery catheters with and without heparin (Rajani, 1979; David, 1981). However, the difference between continuous infusion versus intermittent flushing with heparin has not been studied. We therefore designed a randomized controlled trial of continuous infusion vs. intermittent flushing in 47 infants who required umbilical artery catheters. Twenty-nine received cont. infusion with heparin (1 U/ml) and 18 received intermittent flushing with heparinized saline (1 U/ml). Ten infants weighed ≤1000 g, 19 weighed 1001-1800 g, and 18 weighed >1800 g. We recorded duration of patency, reason for removal, the number and severity of complications (blanching and cyanosis of legs), and clinical history.There were no significant differences in severity of disease, birth wt., birth wt. distribution, number or severity of complications, PT/PTT, size of catheter, glucose concentration, rate of infusion, or drugs. Seventy-six percent of patent catheters remained in place for more than 24 hours (range 8-167 hrs). All of the occlusions occurred in infants who weighed 1800 g. Our findings indicate that continuous heparin infusion is a better way of maintaining patency of an umbilical artery catheter.