The Role of Heparin in Prevention of Neonatal Catheter-related Complications in Peripherally Inserted Central Catheters_Chinese Journal of Evidence-Based Medicine

Authors：

TANG Jun ,  XIONG Ying

The Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

XIONG Ying, Email: tj1234753@sina.com

Keywords：

Peripherally inserted central catheter (PICC); Catheter-related infection (CRI); Heparin; Total nutrient admixture (TNA); Newborn infants

DOI：

10.7507/1672-2531.20100538

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Objective To investigate the role of low-dose heparin added to total nutrient admixture (TNA) solutions in the prevention of catheter related infections (CRIs).
Methods One-hundred three newborn infants with periph-erally inserted central catheter (PICC) were divided into heparin group (n=63) and control group (n=40). The patients in the heparin group received TNA with 0.5 U/ ml heparin. The patients in the control group received TNA without heparin. We retrospectively analyzed the incidence of CRTs in the two groups.
Results We found that the incidence of CRIs was 0 in the heparin group and 12.5% (5/40) in the control group. The incidence of catheter obstruction was 6.3% (4/63) in the heparin group and 20% (8/40) in the control group. The incidence of catheter-tip colonization was 1.58% (1/40) in the heparin group and 17.5% (7/40) in the control group. The incidences of CRIs, catheter obstruction, and catheter-tip colonization were signiicantly lower in the heparin group than those in the control group (P lt;0.05).
Conclusion TNA solutions with 0.5U/ml heparin have decreased catheter obstruction and CRIs.

Citation： TANG Jun,XIONG Ying. The Role of Heparin in Prevention of Neonatal Catheter-related Complications in Peripherally Inserted Central Catheters. Chinese Journal of Evidence-Based Medicine, 2010, 10(9): 1023-1026. doi: 10.7507/1672-2531.20100538 Copy

1.	Durand M, Ramanathan R, Martinelli B, et al. Prospective evaluation of percutaneous central venous Silastic catheters in newborn infants with birth weights of 510 to 3,920 grams. Pediatrics, 1986, 78: 245-250.
2.	Klein JF, Shahrivar F. Use of percutaneous Silastic central venous catheters in neonates and the management of infectious complications. Am J Perinatol, 1992, 9: 261-264.
3.	Nakamura KT, Sato Y, Erenberg A. Evaluation of a percutaneously placed 27-gauge central venous catheter in neonates weighing less than 1200 grams. J Parenter Enteral Nutr, 1990, 14: 295-299.
4.	Salzman MB, Isenberg HD, Shapiro JF, et al. A prospective study of the catheter hub as the portal of entry for microorganisms causing catheter-related sepsis in neonates. J Infect Dis, 1993, 167: 487-490.
5.	Chien LY, Macnab Y, Aziz K, et al. Variations in central venous catheter-related infection risks among Canadian neonatal intensive care units. Pediatr Infect Dis J, 2002, 21: 505-511.
6.	Cardella JF, Cardella K, Bacci N, et al. Cumulative experience with 1,273 peripherally inserted central catheters at a single institution. J Vasc Interv Radiol, 1996, 7: 5-13.
7.	Brismar B, Hardstedt C, Jacobson S, et al. Reduction of catheter-associated thrombosis in parenteral nutrition by intravenous heparin therapy. Arch Surg, 1982, 117: 1196-1199.
8.	Hoshal VL Jr, Ause RG, Hoskins PA. Fibrin sleeve formation on indwelling subclavian central venous catheters. Arch Surg, 1971, 102: 253-258.
9.	Krate-Jacobs B, Sivit CJ, Mejia R, et al. Catheter-related thrombosis in critically ill children: comparison of catheters with and without heparin bonding. J Pediatr, 1995, 126: 50-54.
10.	Spaford PS, Sinkin RA, Cox C, et al. Prevention of central venous catheter-related coagulase negative Staphylococcus sepsis in neonates. J Pediatr, 1994, 125: 260-263.
11.	Maki DG, Stolz SM, Wheeler S, et al. Prevention of central venous catheter-related bloodstream infection by use of an antiseptic-impregnated catheter: a randomized, controlled trial. Ann Intern Med, 1997, 127: 257-266.
12.	Maki DG, Stolz SM, Wheeler S, et al. Prevention of central venous catheter-related bloodstream infection by use of an antiseptic-impregnated catheter: a randomized, controlled trial. Ann Intern Med, 1997, 127: 257-266.
13.	Salzman MB, Rubin LG. Intravenous catheter - related infections. Adv Pediatr Infect Dis, 1995, 10: 337-368.
14.	Salzman MB, Rubin LG. Intravenous catheter - related infections. Adv Pediatr Infect Dis, 1995, 10: 337-368.
15.	Safdar N, Maki DG. Risk of catheter related bloodstream infection with peripherally inserted central venous catheters used in hospitalized patients. Chest, 2005, 128(2): 489-495.
16.	O’Keefe SJ, Bean E, Symmonds K, et al. Clinical evaluation of a ‘3-in-1’ intravenous nutrient solution. S Afr Med J, 1985, 68: 82-86.
17.	Adam B, Baillie GS, Douglas LJ. Mixed species bioilms of Candida albicans and Staphylococcus epidemidis. J Med Microbiol, 2002, 51: 344-349.

1. Durand M, Ramanathan R, Martinelli B, et al. Prospective evaluation of percutaneous central venous Silastic catheters in newborn infants with birth weights of 510 to 3,920 grams. Pediatrics, 1986, 78: 245-250.
2. Klein JF, Shahrivar F. Use of percutaneous Silastic central venous catheters in neonates and the management of infectious complications. Am J Perinatol, 1992, 9: 261-264.
3. Nakamura KT, Sato Y, Erenberg A. Evaluation of a percutaneously placed 27-gauge central venous catheter in neonates weighing less than 1200 grams. J Parenter Enteral Nutr, 1990, 14: 295-299.
4. Salzman MB, Isenberg HD, Shapiro JF, et al. A prospective study of the catheter hub as the portal of entry for microorganisms causing catheter-related sepsis in neonates. J Infect Dis, 1993, 167: 487-490.
5. Chien LY, Macnab Y, Aziz K, et al. Variations in central venous catheter-related infection risks among Canadian neonatal intensive care units. Pediatr Infect Dis J, 2002, 21: 505-511.
6. Cardella JF, Cardella K, Bacci N, et al. Cumulative experience with 1,273 peripherally inserted central catheters at a single institution. J Vasc Interv Radiol, 1996, 7: 5-13.
7. Brismar B, Hardstedt C, Jacobson S, et al. Reduction of catheter-associated thrombosis in parenteral nutrition by intravenous heparin therapy. Arch Surg, 1982, 117: 1196-1199.
8. Hoshal VL Jr, Ause RG, Hoskins PA. Fibrin sleeve formation on indwelling subclavian central venous catheters. Arch Surg, 1971, 102: 253-258.
9. Krate-Jacobs B, Sivit CJ, Mejia R, et al. Catheter-related thrombosis in critically ill children: comparison of catheters with and without heparin bonding. J Pediatr, 1995, 126: 50-54.
10. Spaford PS, Sinkin RA, Cox C, et al. Prevention of central venous catheter-related coagulase negative Staphylococcus sepsis in neonates. J Pediatr, 1994, 125: 260-263.
11. Maki DG, Stolz SM, Wheeler S, et al. Prevention of central venous catheter-related bloodstream infection by use of an antiseptic-impregnated catheter: a randomized, controlled trial. Ann Intern Med, 1997, 127: 257-266.
12. Maki DG, Stolz SM, Wheeler S, et al. Prevention of central venous catheter-related bloodstream infection by use of an antiseptic-impregnated catheter: a randomized, controlled trial. Ann Intern Med, 1997, 127: 257-266.
13. Salzman MB, Rubin LG. Intravenous catheter - related infections. Adv Pediatr Infect Dis, 1995, 10: 337-368.
14. Salzman MB, Rubin LG. Intravenous catheter - related infections. Adv Pediatr Infect Dis, 1995, 10: 337-368.
15. Safdar N, Maki DG. Risk of catheter related bloodstream infection with peripherally inserted central venous catheters used in hospitalized patients. Chest, 2005, 128(2): 489-495.
16. O’Keefe SJ, Bean E, Symmonds K, et al. Clinical evaluation of a ‘3-in-1’ intravenous nutrient solution. S Afr Med J, 1985, 68: 82-86.
17. Adam B, Baillie GS, Douglas LJ. Mixed species bioilms of Candida albicans and Staphylococcus epidemidis. J Med Microbiol, 2002, 51: 344-349.

Chinese Journal of Evidence-Based Medicine

The Role of Heparin in Prevention of Neonatal Catheter-related Complications in Peripherally Inserted Central Catheters

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