• Cir Cir · Sep 2010

    Randomized Controlled Trial

    Usefulness of intravenous heparin to prevent thrombosis of central venous catheter in children.

    • Eduardo Bracho-Blanchet, Jorge Cortés-Sauza, Roberto Dávila-Pérez, Pablo Lezama-Del Valle, César Villalobos-Alfaro, and Jaime Nieto-Zermeño.
    • Departamento de Cirugía General, Hospital Infantil de México "Federico Gómez," Secretaría de Salud, México, D. F., Mexico. eduardo@fambracho.org
    • Cir Cir. 2010 Sep 1; 78 (5): 423-9.

    Backgroundcentral venous catheter (CVC) thrombosis in children is a main issue and its prevention with intravenous heparin is still controversial. The aim of this study was to evaluate efficacy of intravenous heparin in preventing CVC thrombosis both clinically and macroscopically.Methodswe conducted a randomized clinical trial in a tertiary care children's hospital with patients <18 years of age with CVC. Experimental group included addition of heparin at 2 IU/ml of intravenous fluids (IV), whereas the control group did not include heparin.Resultsseventy six lumen of catheters were included, 38 in each group. Both groups were homogeneous in epidemiological variables. Macroscopic thrombus was found in 27 (35.5%) lumen of catheters. The group with heparin showed thrombus in 7.8% and 63% in the control group (p <0.0001 with relative risk (RR) of 20 and confidence interval (CI) at 95% (5.1-77.2). Clinical evaluation showed adequate flow in the IV of the heparin group in 94.7% and 57.8% in the control group (p <0.001). Blood return through the lumen of catheters with heparin was present in 86.8% and 42.1% in the control group (p <0.001). Mean time for catheters was 14.3 days. There were no side effects or prolonged partial thromboplastin time.Conclusionsheparin infusion at 2 IU/ml is safe and effective in preventing CVC thrombosis in children.

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