• Lydia R Maurer, Casey M Luckhurst, Arzo Hamidi, Kelly A Newman, Megan E Barra, Majed El Hechi, Ava Mokhtari, Kerry Breen, Laura Lux, Laura Prout, Jarone Lee, Edward A Bittner, David Chang, Kaafarani Haytham M A HMA Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Boston, MA, United States of America., Rachel P Rosovsky, and Russel J Roberts.
• Department of Surgery, Massachusetts General Hospital, Boston, MA, United States of America.
• J Crit Care. 2020 Dec 1; 60: 253-259.

PurposeCritically ill patients with Coronavirus Disease 2019 (COVID-19) have high rates of line thrombosis. Our objective was to examine the safety and efficacy of a low dose heparinized saline (LDHS) arterial line (a-line) patency protocol in this population.Materials And MethodsIn this observational cohort study, patients ≥18 years with COVID-19 admitted to an ICU at one institution from March 20-May 25, 2020 were divided into two cohorts. Pre-LDHS patients had an episode of a-line thrombosis between March 20-April 19. Post-LDHS patients had an episode of a-line thrombosis between April 20-May 25 and received an LDHS solution (10 units/h) through their a-line pressure bag.ResultsForty-one patients (pre-LDHS) and 30 patients (post-LDHS) were identified. Baseline characteristics were similar between groups, including age (61 versus 54 years; p = 0.24), median Sequential Organ Failure Assessment score (6 versus 7; p = 0.67) and systemic anticoagulation (47% versus 32%; p = 0.32). Median duration of a-line patency was significantly longer in post-LDHS versus pre-LDHS patients (8.5 versus 2.9 days; p < 0.001). The incidence of bleeding complications was similar between cohorts (13% vs. 10%; p = 0.71).ConclusionsA LDHS protocol was associated with a clinically significant improvement in a-line patency duration in COVID-19 patients, without increased bleeding risk.Copyright © 2020 Elsevier Inc. All rights reserved.

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