de Neef M, Heijboer H, van Woensel J B M, de Haan R J
Department of Paediatric Intensive Care, Emma Children's Hospital, Academic Medical Center (AMC), Amsterdam, The Netherlands.
Pediatr Hematol Oncol. 2002 Dec;19(8):553-60. doi: 10.1080/08880010290097404.
This study evaluates the efficacy of heparinization in prolonging patency of arterial and central venous catheters in children. A randomized double-blind trial in a tertiary 10-bed pediatric intensive care unit was used to evaluate 300 children (age older than 4 weeks, younger than 18 years). Trial medication consisted of either NaCl 0.9% infusion or NaCl 0.9% infusion to which 1 IU of heparin per milliliter was added. The number of nonpatent arterial and central venous catheters and the duration of stay of patent arterial and central venous catheters were measured. There was a significant risk increase for nonpatency in the nonheparinized arterial catheters (relative risk [RR]: 3.54; 95% confidence interval [CI]: 1.01-12.42). No significant risk increase for nonpatency could be demonstrated for the nonheparinized central venous catheters (RR: 7.63; 95% CI: 0.40-145). The median duration of stay of the patent arterial and central venous catheters was similar for both treatment groups. These results indicate that the use of normal saline in arterial catheters is associated with an increased frequency of catheter nonpatency as compared with heparinized saline.
本研究评估肝素化在延长儿童动脉和中心静脉导管通畅时间方面的疗效。在一家拥有10张床位的三级儿科重症监护病房进行了一项随机双盲试验,以评估300名儿童(年龄大于4周、小于18岁)。试验用药包括0.9%氯化钠注射液或每毫升添加1国际单位肝素的0.9%氯化钠注射液。测量了不通畅的动脉和中心静脉导管数量以及通畅的动脉和中心静脉导管的留置时间。未肝素化的动脉导管出现不通畅的风险显著增加(相对风险[RR]:3.54;95%置信区间[CI]:1.01 - 12.42)。未肝素化的中心静脉导管未显示出不通畅风险的显著增加(RR:7.63;95% CI:0.40 - 145)。两个治疗组通畅的动脉和中心静脉导管的中位留置时间相似。这些结果表明,与肝素化盐水相比,动脉导管使用生理盐水会导致导管不通畅的频率增加。