Once daily saline flush keeps pediatric IV catheters patent

By Reuters Staff

NEW YORK (Reuters Health) - Normal saline flushing once per 24 hours maintains peripheral intravenous catheter patency at least as well a twice-daily approach and may reduce catheter-related complications, according to Italian investigators.

In a January 14 online paper in the Archives of Disease in Childhood, Dr. Chiara Zanchi of the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste and colleagues note that both heparin and saline flushes have similar efficacy in maintaining peripheral intravenous lock.

However, information is lacking on optimal flushing frequency with normal saline. To investigate, the team studied 400 children ages 1 to 17 who were randomly assigned to saline flushing every 12 hours or every 24 hours. Children who needed continuous infusion or were on programmed therapy were excluded.

Completed follow-up of 397 of the children showed that 15 (7.6%) of the twice-daily flushing group experienced catheter occlusion compared to only 9 (4.5%) of the once-daily group.

Although the difference did not reach significance overall, catheter-related complications - blood extravasation, pain, erythema, and swelling - were more common in the 12-hour group (12.1% versus 9.5%). The difference for erythema reached significance (2.5% versus 0.0%; p=0.02).

The researchers note that these results are important because they may reduce costs by requiring less material and nursing time "and unnecessary manipulation of the catheters, which can cause distress in younger children and their parents."

They also add that compared to heparin, saline may reduce side effects and complications and "normal saline displays none of the drug incompatibilities associated with the use of heparin solution."

Dr. Zanchi did not respond to requests for comments.

The authors reported no external funding or disclosures.

SOURCE: http://bmj.co/1CILRLq

Arch Dis Child 2015.

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