肝素盐水与0.9%氯化钠用于维持健康犬中心静脉导管通畅性的比较。
Comparison of heparinized saline and 0.9% sodium chloride for maintaining central venous catheter patency in healthy dogs.
作者信息
Vose Julieann, Odunayo Adesola, Price Joshua M, Daves Maggie, Schildt Julie C, Tolbert M Katherine
机构信息
Department of Small Animal Clinical Sciences, University of Tennessee-Knoxville, Knoxville, TN, USA.
Office of Information Technology, University of Tennessee-Knoxville, Knoxville, TN, USA.
出版信息
PeerJ. 2019 May 31;7:e7072. doi: 10.7717/peerj.7072. eCollection 2019.
BACKGROUND
The purpose of this study was to determine whether heparinized saline (HS) would be more effective in maintaining the patency of central venous catheters (CVCs) in dogs compared to 0.9% sodium chloride. This was a prospective randomized blinded study conducted at a University Veterinary Teaching Hospital.
METHODS
A total of 24 healthy purpose-bred dogs were randomized into two groups: a treatment and a control group. A CVC was placed in the jugular vein of each dog. Each dog in the treatment group had their CVC flushed with 10 IU/mL HS, while dogs in the control group had their CVC flushed with 0.9% sodium chloride every 6 h for 72 h. Immediately prior to flushing, each catheter was evaluated for patency by aspiration of blood. The catheter site was also evaluated for phlebitis, and a rectal temperature was obtained in each dog every 6 h. Prothrombin (PT) and activated partial thromboplastin (aPTT) times were evaluated prior to the administration of any flush solution. Results were then compared to values obtained 72 h later.
RESULTS
All CVCs in both groups were patent after 72 h, which was demonstrated by aspiration of blood and ease of flushing the catheter. Two CVCs in the 0.9% sodium chloride group had a negative aspiration at hour 12 and 36, respectively. One CVC in the HS group had a negative aspiration at hour 18. Signs of phlebitis occurred in three dog: two in the 0.9% sodium chloride group and one in the HS group. No dog was hyperthermic (>103 °F). Two catheters were inadvertently removed by dogs in the HS group during the study. There were no significant differences in catheter patency, incidence of phlebitis, or incidence of negative aspirations between both groups. aPTT and PT values remained within the normal reference range for all dogs in both groups. Ultimately, 0.9% sodium chloride was as effective as 10 IU/mL HS in maintaining the patency of CVCs for up to 72 h in healthy dogs. Further evaluation in clinical patients is warranted.
背景
本研究的目的是确定与0.9%氯化钠相比，肝素盐水（HS）在维持犬中心静脉导管（CVC）通畅方面是否更有效。这是一项在大学兽医教学医院进行的前瞻性随机双盲研究。
方法
总共24只健康的专用犬被随机分为两组：治疗组和对照组。在每只犬的颈静脉放置一根CVC。治疗组的每只犬的CVC用10 IU/mL的HS冲洗，而对照组的犬每6小时用0.9%氯化钠冲洗CVC，共冲洗72小时。在冲洗前，通过抽吸血液评估每根导管的通畅情况。还对导管部位进行静脉炎评估，并且每6小时测量每只犬的直肠温度。在给予任何冲洗溶液之前评估凝血酶原（PT）和活化部分凝血活酶（aPTT）时间。然后将结果与72小时后获得的值进行比较。
结果
72小时后两组所有CVC均通畅，这通过抽吸血液和易于冲洗导管得以证明。0.9%氯化钠组的两根CVC分别在第12小时和36小时抽吸为阴性。HS组的一根CVC在第18小时抽吸为阴性。三只犬出现静脉炎迹象：0.9%氯化钠组两只，HS组一只。没有犬体温过高（>103°F）。在研究期间，HS组有两只犬意外拔除了导管。两组之间在导管通畅性、静脉炎发生率或抽吸阴性发生率方面没有显著差异。两组所有犬的aPTT和PT值均保持在正常参考范围内。最终，在健康犬中，0.9%氯化钠在维持CVC通畅长达72小时方面与10 IU/mL HS同样有效。有必要在临床患者中进行进一步评估。
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