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Comparison between the effects of normal saline with and without heparin for the prevention and management of arterial catheter occlusion: a triple-blinded randomized trial

Abstract

Purpose

We aimed to compare the effects of saline with and without heparin on the catheter-occlusion rate and coagulation-related blood test results for the management of arterial catheters among patients admitted to a short-term intensive care unit postoperatively.

Methods

This prospective, triple-blinded, randomized controlled study recruited patients aged 20–90 years scheduled to undergo radial arterial catheter insertion and postoperative intensive care unit admission between February and August 2019. Patients were randomly allocated to two groups (1:1 ratio) depending on the use of heparin: study (normal saline with heparin, 3000 units to 500 ml of normal saline) and control (normal saline without heparin) groups with arterial catheters. The allocated management method was employed immediately after intensive care unit admission. Occlusion assessment (every 12 h), arterial blood gas tests (every 6 h), and blood sample collection (every 24 h) were performed. The occlusion of arterial catheter was assessed using occlusion rate, and blood test results were assessed using a linear mixed model.

Results

There were 147 patients in the arterial catheter groups. There were no significant differences in occlusion rates and changes in platelet counts and activated partial thromboplastin time between the groups with arterial (p = 0.98, 0.16, and 0.32, respectively) catheters during the first 6 days after intensive care unit admission.

Conclusion

Normal saline with and without heparin showed similar efficiency for both the prevention of occlusion and the results of coagulation.

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Acknowledgements

We thank the medical staff of the Anaesthesiology Department, all nurses of the operating room, and all nurses of surgical intensive care unit at Nagoya University Hospital for their assistance.

Funding

Support was provided solely from institutional and/or departmental sources, and this research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Affiliations

Authors

Contributions

All authors contributed to the study conception and design. TT, MA, TI, and YK helped with data collection, measurement, analysis, and interpretation. All authors are responsible for writing the paper and for its contents. EK, MK, YM, and AF are responsible for the treatment that the nurses carried out. YM and TI are responsible for the double-blind drug preparation performed by the pharmacists.

Corresponding author

Correspondence to Takahiro Tamura.

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Tamura, T., Kobayashi, E., Kawaguchi, M. et al. Comparison between the effects of normal saline with and without heparin for the prevention and management of arterial catheter occlusion: a triple-blinded randomized trial. J Anesth 35, 536–542 (2021). https://doi.org/10.1007/s00540-021-02949-1

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Keywords

  • Arterial catheter
  • Heparin
  • Occlusion management
  • Platelet count
  • Thrombocytopenia