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Avoiding Heparinization of Arterial Line and Maintaining Acceptable Arterial Waveform After Cardiac Surgery: A Randomized Clinical Trial.

Alizadehasl A, Ziyaeifard M, Peighambari M, Azarfarin R, Golbargian G, Bakhshandeh H - Res Cardiovasc Med (2015)

Bottom Line: Accuracy of BP measurement mostly depends on patency of arterial catheter and acceptable waveform.There were no statistically significant differences between heparinized and non-heparinized saline groups regarding acceptable arterial waveforms in all the three postoperative days (all P values > 0.05).Using non-heparinized normal saline is suitable to maintain acceptable arterial waveform for short-term (three days) after adult cardiac surgery considering potential adverse effects of heparin.

View Article: PubMed Central - PubMed

Affiliation: Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.

ABSTRACT

Background: Invasive and continuous blood pressure (BP) monitoring is crucial after cardiac surgery. Accuracy of BP measurement mostly depends on patency of arterial catheter and acceptable waveform. Heparinized saline flush usually used for this purpose may be accompanied by potential heparin adverse effects.

Objectives: The aim of this study was to compare heparinized and non-heparinized saline flush to maintain acceptable arterial waveform after cardiac surgery.

Materials and methods: In a double blind randomized trial study, 100 patients undergoing elective cardiac surgery were randomized to using heparinized (n = 50) or non-heparinized (normal) saline flush (n = 50) to maintain patency of arterial catheter after operation. Indwelling arterial catheters were checked daily for acceptable arterial waveform for three days as primary outcome measures.

Results: Frequency of acceptable arterial waveform ranged from 66% to 80%, in first, second and third postoperative days. There were no statistically significant differences between heparinized and non-heparinized saline groups regarding acceptable arterial waveforms in all the three postoperative days (all P values > 0.05).

Conclusions: Using non-heparinized normal saline is suitable to maintain acceptable arterial waveform for short-term (three days) after adult cardiac surgery considering potential adverse effects of heparin.

No MeSH data available.


Related in: MedlinePlus

The Study Flow Diagram
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fig21076: The Study Flow Diagram

Mentions: In a double blind randomized clinical trial study, 100 patients undergoing elective cardiac surgery entered the study. The study was approved in institutional ethic committee and all patients filled out informed consents. The patients were randomized to use heparinized (n = 50) or non-heparinized (normal) saline flush (n = 50) to maintain patency of arterial catheter after operation. The randomization method was simple and random allocation was performed using an online method (URL:http://www.graphpad.com/quickcalcs/randomize2/). The random allocation was concealed from researcher and kept confidential with third person until the end of study. The study flow diagram is shown in Figure 1. Inclusion criteria were patients who had arterial catheters, PT (prothrombin time) up to 13 seconds, activated partial prothrombin time (aPTT) up to 45 seconds, platelet count 140000 - 440000 mm3, filling out a consent form for the study and placement of catheters in intensive care unit. Exclusion criteria were known allergy to heparin, history of heparin-induced thrombocytopenia, coagulation disorder before using heparin, more than five times effort to put the catheter in place, thrombocytopenia with platelets less than 100000 mm3 and simultaneous participation in any other study.


Avoiding Heparinization of Arterial Line and Maintaining Acceptable Arterial Waveform After Cardiac Surgery: A Randomized Clinical Trial.

Alizadehasl A, Ziyaeifard M, Peighambari M, Azarfarin R, Golbargian G, Bakhshandeh H - Res Cardiovasc Med (2015)

The Study Flow Diagram
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4588703&req=5

fig21076: The Study Flow Diagram
Mentions: In a double blind randomized clinical trial study, 100 patients undergoing elective cardiac surgery entered the study. The study was approved in institutional ethic committee and all patients filled out informed consents. The patients were randomized to use heparinized (n = 50) or non-heparinized (normal) saline flush (n = 50) to maintain patency of arterial catheter after operation. The randomization method was simple and random allocation was performed using an online method (URL:http://www.graphpad.com/quickcalcs/randomize2/). The random allocation was concealed from researcher and kept confidential with third person until the end of study. The study flow diagram is shown in Figure 1. Inclusion criteria were patients who had arterial catheters, PT (prothrombin time) up to 13 seconds, activated partial prothrombin time (aPTT) up to 45 seconds, platelet count 140000 - 440000 mm3, filling out a consent form for the study and placement of catheters in intensive care unit. Exclusion criteria were known allergy to heparin, history of heparin-induced thrombocytopenia, coagulation disorder before using heparin, more than five times effort to put the catheter in place, thrombocytopenia with platelets less than 100000 mm3 and simultaneous participation in any other study.

Bottom Line: Accuracy of BP measurement mostly depends on patency of arterial catheter and acceptable waveform.There were no statistically significant differences between heparinized and non-heparinized saline groups regarding acceptable arterial waveforms in all the three postoperative days (all P values > 0.05).Using non-heparinized normal saline is suitable to maintain acceptable arterial waveform for short-term (three days) after adult cardiac surgery considering potential adverse effects of heparin.

View Article: PubMed Central - PubMed

Affiliation: Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.

ABSTRACT

Background: Invasive and continuous blood pressure (BP) monitoring is crucial after cardiac surgery. Accuracy of BP measurement mostly depends on patency of arterial catheter and acceptable waveform. Heparinized saline flush usually used for this purpose may be accompanied by potential heparin adverse effects.

Objectives: The aim of this study was to compare heparinized and non-heparinized saline flush to maintain acceptable arterial waveform after cardiac surgery.

Materials and methods: In a double blind randomized trial study, 100 patients undergoing elective cardiac surgery were randomized to using heparinized (n = 50) or non-heparinized (normal) saline flush (n = 50) to maintain patency of arterial catheter after operation. Indwelling arterial catheters were checked daily for acceptable arterial waveform for three days as primary outcome measures.

Results: Frequency of acceptable arterial waveform ranged from 66% to 80%, in first, second and third postoperative days. There were no statistically significant differences between heparinized and non-heparinized saline groups regarding acceptable arterial waveforms in all the three postoperative days (all P values > 0.05).

Conclusions: Using non-heparinized normal saline is suitable to maintain acceptable arterial waveform for short-term (three days) after adult cardiac surgery considering potential adverse effects of heparin.

No MeSH data available.


Related in: MedlinePlus