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InStock 2. Caption Directions Ingredients Warnings Because your eyes are so important. Choose Your Location. Delivery options and delivery speeds may vary for different locations. Check for occlusion in the artery catheters based-on blood return and monitoring devices were connected to the patient. If blood returned, catheter was opened. Arterial catheter should be an appropriate response to the flush test.
It means that with the serum flush in the arterial catheter, arterial wave disappeared and viewed direct line in the monitoring device. Sing of the catheter should also have a rapid decline to below the baseline. The flash test was used to check the venous catheter occlusion blood return to the catheter and positive response.
Both the patients and primary endpoint assessor were blind to composition of flushing solutions double blinded trial. The data regarding patients were analyzed by SPSS for windows statistical package v. Mean values of continuous variables were compared between the two study groups by independent sample t-test.
The approach and plan for statistical analysis was intention to treat analysis. Hundred patients were enrolled and completed the study based on the inclusion and exclusion criteria.
Demographic and clinical data are presented in Table 1. In the current study, none of the central venous catheters were blocked. The results of the current study showed no statistically significant difference regarding the patients' demographic characteristics such as age and gender between the two groups. The most common site of arterial catheters similar to those of the previous studies was radial artery. The proportion of arterial catheters placement sites including radial, brachial and femoral arteries were similar to those of the previous studies and there was no statistically significant difference between the two groups The sites of venous catheters between the two groups were similar to those of the previous studies and not significantly different 8.
In the current study, the arterial catheters manipulation including displacement and lavage were similar to those of the previous studies and there was no statistically significant difference between the two groups 5. Central venous catheters manipulation including displacement and lavage between the two groups of the current study was not significantly different. Arterial catheters occlusion between the two groups was not significantly different, similar to those of the previous studies.
Also central venous catheters occlusions between the two groups were not significantly different, similar to those of the previous studies Also the effect of heparinized saline with normal saline solutions in patency of peripheral venous catheters in the adult and newborn was studied, which were not significantly different 14 , In a current systematic review study Kordzadeh et al.
However the current study assessed this issue in short term period and found no significant difference. Cardiac surgery includes vascular and valve surgery, and in the current study there was no statistically significant difference between the two groups, but in the other studies were not surveyed. Variable alteration during three days of patients follow up including catheters occlusion and other parameters did not significantly change that was similar to the obtained results of the studies in which patients were followed up from several days to 12 months 5 , 8 , 16 , Based on the finding of the current double blind randomized clinical trial, use of heparinized saline solutions compared with normal saline solutions did not prolong the patency of arterial and central venous catheters in short term postoperative period.
Finding of the study suggested that normal saline solution can be used as the standard solution to prevent catheter occlusion after cardiac surgery. Therefore, all medical centers are suggested to prevent heparin complications such as allergic reaction, local tissue injury, bleeding, thrombus and thrombocytopenia related to use of heparin in patients with arterial and central venous catheter; normal saline solution can be used to prevent catheter occlusion as a safe alternative solution.
It seems that the use of heparinized saline and normal saline solution in preventing occlusion of arterial and central venous catheter has no difference. Our finding only applicable to cardiac surgery patients that have arterial or central venous line catheters for short time period 3 three days post-operatively. Therefore these dada could not be generalizable to chronic medical situations. Arterial and venous catheters patency were assessed only for three postoperative days; therefore no data were provided on prolonged maintenance of indwelling catheters by heparinized or normal saline solutions flush.
Regarding relatively low frequency of arterial or venous catheter occlusion, conducting large scale studies could assess the difference of heparinized and normal saline solutions flush better.
Authors wish to acknowledge their gratitude to the ethics committee of Tehran Rajaie cardiovascular medical and research center for granting approval to conduct this research.
Authors would like to thanks all the colleagues in the intensive care unit and Mr. Mohammad Masbi and Mr. Mohammad Ali Najafikhah. National Center for Biotechnology Information , U.
Journal List Anesth Pain Med v. Anesth Pain Med. Published online Aug Author information Article notes Copyright and License information Disclaimer.
This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4. This article has been cited by other articles in PMC. Abstract Background: Heparinized saline solution is used to prevent occlusion in the arterial catheters and central venous pressure monitoring catheters.
Continue to use whatever is easiest for your team. I still almost always use saline myself. PMID: An approach to the initial management of the asthma patient presenting to the emergency department in extremis. A simplified approach to the initial assessment and management of emergency department patients with massive hemoptysis. Given the many commentaries in the FOAM community, we are all familiar […]. Everything old is new again. So no difference — i. Interesting to have made 90 day survival the end point of interest.
I thought our main concerns with saline were around hyperchloremic metabolic acidosis and kidney injury when giving large boluses or as maintenance fluids for several days. We often give that in the first hour so what does this prove? If you have someone in DKA are you going to give just 1.
This does not apply to my ED nor any I have worked in. I agree the amount of fluid is small, although I do think practice has trended in this direction. There were real life patients, after all. I think it is fine to be skeptical of the generalizability of these results, as long as one is equally or even more skeptical of the difference seen in the SMART trial with only 1 L of IV fluids.
And if we are going to ignore SMART, then then entirety of this literature indicates that normal saline is just fine for the vast majority of our patients. I have to say I agree with some of the last two comments. I always thought we were concerned about rapid large normal saline infusions. However it looks like 1.
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