Comparison of heparinized and nonheparinized solutions for maintaining patency of arterial and pulmonary artery catheters

Abstract

Arterial and pulmonary artery catheters are often used in the management of critically ill patients. If heparin were not necessary to maintain the patency of arterial and pulmonary artery catheters, these patients could avoid exposure to heparin. The purpose of this study was to determine if the failure rate of arterial and pulmonary artery catheters differs depending on whether a nonheparinized or heparinized solution is used. The null hypothesis was that catheter failure rates would not differ. The study was done at a large tertiary medical center in the northeastern United States, and all subjects who had pulmonary artery or arterial catheters inserted were included in the study. A solution of 1 U of heparin per 1 mL of normal saline was used to maintain the patency of the arterial catheter and the distal portion of the pulmonary artery catheter in one group; normal saline alone was used in the other group. Variables used to monitor catheter patency and the reasons for catheter removal were recorded. Failure rates of pulmonary artery catheters were not significantly different between the two groups. For arterial catheters, however, the failure rate was significantly different between the two groups, regardless of whether the subjects had received other anticoagulants. The failure rate of pulmonary artery catheters was not affected by the use of nonheparinized solutions. Arterial catheters failed less often when they were maintained with heparinized solutions. The authors recommend that all arterial catheters be maintained with heparinized solutions, unless use of heparin is contraindicated.