Objective To investigate the role of low-dose heparin added to total nutrient admixture (TNA) solutions in the prevention of catheter related infections (CRIs). Methods One-hundred three newborn infants with periph-erally inserted central catheter (PICC) were divided into heparin group (n=63) and control group (n=40). The patients in the heparin group received TNA with 0.5 U/ ml heparin. The patients in the control group received TNA without heparin. We retrospectively analyzed the incidence of CRTs in the two groups. Results We found that the incidence of CRIs was 0 in the heparin group and 12.5% (5/40) in the control group. The incidence of catheter obstruction was 6.3% (4/63) in the heparin group and 20% (8/40) in the control group. The incidence of catheter-tip colonization was 1.58% (1/40) in the heparin group and 17.5% (7/40) in the control group. The incidences of CRIs, catheter obstruction, and catheter-tip colonization were signiicantly lower in the heparin group than those in the control group (Plt;0.05). Conclusion TNA solutions with 0.5U/ml heparin have decreased catheter obstruction and CRIs.
ObjectiveTo systematically review the effect of pre-treating the catheters with dexamethasone for preventing PICC-associated phlebitis. MethodsWe electronically searched PubMed, EMbase, The Cochrane Library (Issue 4, 2012), CNKI, CBM, WanFang Data and CQVIP for studies about pre-treating the catheters with dexamethasone to prevent PICC-associated phlebitis from inception to March 2013. Relevant studies including grey literature were also manually searched. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data and evaluated the methodological quality of the included studies. Then meta-analysis was performed using the software RevMan 5.0. ResultsA total of 13 studies involving 1 965 cases (1 025 cases in the dexamethasone group, and 940 cases in the control group) were included. The results of meta-analysis showed that pre-treating the catheters with dexamethasone could significantly decrease the incidence of PICC-associated phlebitis (RR=0.29, 95%CI=0.22 to 0.39, P < 0.000 1). However, no significant difference was found for the PICC-associated other complications, such as pipe blockage, bleeding, swelling of puncture site, allergy and atopic catheter. ConclusionPre-treating the catheters with dexamethasone soltion before inserting could reduce the incidence of PICC-associated phlebitis. The aforementioned conclusion needs to be further validated by more high-quality and large-scale randomized controlled trials.