Lack of difference between continuous versus intermittent heparin infusion on maintenance of intra-arterial catheter in postoperative pediatric surgery: a randomized controlled study

Maria Carolina Witkowski,Cora Maria F Firpo,Maria Antonieta P De Moraes

doi:10.1590/s0103-05822013000400015

Abstract

OBJECTIVE: To compare two systems of arterial catheters maintenance in postoperative pediatric surgery using intermittent or continuous infusion of heparin solution and to analyze adverse events related to the site of catheter insertion and the volume of infused heparin solution. METHODS: Randomized control trial with 140 patients selected for continuous infusion group (CIG) and intermittent infusion group (IIG). The variables analyzed were: type of heart disease, permanence time and size of the catheter, insertion site, technique used, volume of heparin solution and adverse events. The descriptive variables were analyzed by Student's t-test and the categorical variables, by chi-square test, being significant p<0.05. RESULTS: The median age was 11 (0-22) months, and 77 (55%) were females. No significant differences between studied variables were found, except for the volume used in CIG (12.0±1.2mL/24 hours) when compared to IIG (5.3±3.5mL/24 hours) with p<0.0003. CONCLUSIONS: The continuous infusion system and the intermittent infusion of heparin solution can be used for intra-arterial catheters maintenance in postoperative pediatric surgery, regardless of patient's clinical and demographic characteristics. Adverse events up to the third postoperative day occurred similarly in both groups. However, the intermittent infusion system usage in underweight children should be considered, due to the lower volume of infused heparin solution [ClinicalTrials.gov Identifier: NCT01097031].

Highlights

The process of post-operative cardiac surgery depends on several factors, from the type of heart disease and the weight of the patient to the hospital structure, including a team of specialized health and appropriate equipment
A systematic review and meta-analysis evaluated the effect of heparin, length of stay, and complications of arterial and venous catheters in children and adults admitted to intensive care
The findings indicate that the intermittent use of heparin solution in concentrations of 10UI/mL was beneficial, compared to the isolated use of 0.9% saline solution

Summary

Introduction

The process of post-operative cardiac surgery depends on several factors, from the type of heart disease and the weight of the patient to the hospital structure, including a team of specialized health and appropriate equipment. The use of arterial catheters is essential for patient care, the occurrence of adverse events that should be detected and treated early is frequent[8,9,10,11,12,13,14]. The findings indicate that the intermittent use of heparin solution in concentrations of 10UI/mL was beneficial, compared to the isolated use of 0.9% saline solution. With this concentration of heparin solution, catheters remained permeable for a longer time compared to the group receiving saline solution at 0.9%(15)

Results

Discussion

Conclusion