A comparison of normal versus heparinised saline in maintaining patency of central venous catheters in adults

Abstract

Central venous catheters (CVCs) are devices frequently used for long-term intravenous access such as chemotherapy, long-term antibiotics and administration of blood products. However, if not maintained and kept patent serious complications may occur. The aim of this dissertation is to find out whether normal saline is as equally effective to heparinised saline in maintaining central venous catheter patency. The research question introduced for this dissertation was formulated using the PICO framework- “How effective is heparinised saline (intervention) when maintaining patency (outcome) in adults (population) with a central venous catheter compared to sodium chloride (comparison). The search process was carried out between May and August 2022. A total number of five articles were retrieved and analysed. The inclusion criteria consisted of an adult population (18 years and over), normal saline and heparinised saline only for flushing and maintaining patency, central venous catheters, systematic reviews, RCTs and published after 2012 (10 years). The exclusion criteria consisted of a paediatric population (under 18 years), other types of flushing solutions for flushing and maintaining patency, peripherally inserted catheters, other types of studies and published before 2012 (more than 10 years). The CASP tool for systematic reviews was used to critically appraise the included studies. Legal and ethical issues were also discussed in relation to the studies methodologies. Findings show that normal saline is equally effective to heparinised saline and seem to achieve similar results in maintaining catheter patency. Recommendations for potential large-scale studies on specific CVC lines was recommended for future research. Further nursing assessments and history taking was recommended for the clinical practice. Keeping up with international guidelines and revision of local guidelines was recommended for the education and management purpose.