Bailey M J
Br Med J. 1979 Jun 23;1(6179):1671-3. doi: 10.1136/bmj.1.6179.1671.
To assess whether adding low-dose heparin to the infusate of patients receiving parenteral nutrition reduced the incidence of septic complications related to the central venous catheter, 80 consecutive patients requiring intravenous feeding were studied. Half of these patients received heparin 1 unit/ml of infusate, while in the remaining 40 (controls) an equal volume of physiological saline was added to the infusate. Strict criteria for the management of the indwelling CVC were observed. The catheter tips were cultured after removal: only one was infected in the heparin group compared with nine in the control group. This significant reduction may have been due to the heparin preventing a fibrin sleeve from forming around the catheter tip. It is recommended that, as well as observing the usual aseptic precautions in managing the cannula, 500 units of heparin are added to each 500 ml of fluid infused to reduce the incidence of catheter-associated sepsis.
为评估在接受肠外营养的患者输注液中添加低剂量肝素是否能降低与中心静脉导管相关的脓毒症并发症的发生率，对80例连续需要静脉喂养的患者进行了研究。这些患者中有一半在输注液中接受1单位/毫升的肝素，而其余40例（对照组）则在输注液中添加等量的生理盐水。观察了留置中心静脉导管的严格管理标准。导管尖端在拔除后进行培养：肝素组仅有1例感染，而对照组有9例感染。这种显著降低可能是由于肝素阻止了导管尖端周围形成纤维蛋白套。建议在管理套管时除了遵守常规的无菌预防措施外，每500毫升输注液中添加500单位肝素以降低导管相关脓毒症的发生率。
