Should I use Heparin or saline for flushing CVADs?
In Adults
A systematic review and meta-analysis, including 9 studies and 3,113 patients, was conducted to determine if heparin or normal saline flushes were better for maintaining the patency of CVADs and found little evidence to support the use of heparin flushes compared with normal saline flushes, however, the quality of evidence was very low [1]. More high-quality research is needed before making firm recommendations but, given the extra cost and risk associated with heparin use, normal saline flushes may be a more cost-effective way of maintaining CVAD patency with less risk.
In Long term CVADs in Paediatrics
To prevent CVAD occlusion in paediatric oncology patients, a recent systematic review and meta- analysis demonstrated no significant difference between either heparin or normal saline flushing [2]. Given the higher risk profile of heparin, normal saline flushing should be recommended to reduce the risk of CVAD occlusion.
References:
Sharma SK, Mudgal SK, Gaur R, Sharma R, Sharma M, Thakur K. Heparin flush vs. normal saline flush to maintain the patency of central venous catheter among adult patients: A systematic review and meta-analysis. J Family Med Prim Care. 2019 Sep 30;8(9):2779-2792. doi: 10.4103/jfmpc.jfmpc_669_19.
Semerci R, Bingöl H, Bay Büyükkapu S, Kudubes AA, Bekta? M, Kebudi R. Comparison of heparin and saline for prevention of central venous catheter occlusion in pediatric oncology: A systematic review and meta-analysis. Semin Oncol Nurs. 2023 Aug;39(4):151426. doi: 10.1016/j.soncn.2023.151426.
Last Updated on: 16/01/2025
