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| Documento principal | 2.43 MB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
Contexto: Na manutenção e otimização de cateteres venosos centrais (CVC)
persistem controvérsias acerca da solução recomendada para manter a permeabilidade.
Este estudo surge na sequência de determinar qual é a solução (heparinizada ou soro
fisiológico) mais eficaz na redução do risco de oclusões, infeções e de outras complicações.
Objetivo: Determinar a eficácia do flush das soluções heparinizadas em comparação
com o flush de soro fisiológico 0,9% na permeabilidade de CVC em adultos.
Métodos: A realização da revisão sistemática com meta-análise seguiu os princípios
propostos pelo Cochrane Handbook. A análise crítica, a extração e a síntese dos dados foi
realizada por dois investigadores isoladamente e a análise estatística efetuada com recurso
ao programa RevMan 5.2.8.
Resultados: Foram incluídos seis randomized controlled trials envolvendo um total de
2278 utentes. Os resultados da meta-análise apontam não existir diferenças significativas
entre as soluções em relação à eficácia de manter a permeabilidade dos CVC (RR= 0.83, IC
95%=0.55-1.26; p=0.39). Por outro lado a utilização de soro fisiológico também não constitui
per si um fator que aumente o risco de infeção associada ao CVC.
Conclusões: O soro fisiológico é suficiente para manter a permeabilidade dos CVC
prevenindo os riscos associados à administração da heparina.
Abstract Effectiveness of heparin versus 0.9% saline flushing to maintain patency of central venous catheters in adults Context: In the maintenance and optimization of central venous catheters (CVC) controversy persists about the recommended solution to maintain patency. This study aims to determine which solution (heparin or saline) are more effective in reducing the risk of occlusions, infections and other complications. Objective: To determine the effectiveness of the heparin flush versus 0.9% saline flush to maintain patency of CVC in adults. Methods: We perform a systematic review and meta-analysis following the principles proposed by the Cochrane Handbook. The critical analysis, extraction and synthesis of data were performed by two investigators separately and statistical analysis performed using RevMan 5.2.8. Results: We included six randomized controlled trials involving a total of 2278 patients. The results of the meta-analysis indicate no significant differences between the effectiveness of solutions to maintaining the CVC patency (RR=0.83, 95% CI=0.55-1.26; p=0.39). On the other hand, saline flushing does not constitute per se a factor that increases the risk of infection associated with the CVC. Conclusions: The saline solution is sufficient to maintain the permeability of the CVC preventing the risks associated with the administration of heparin.
Abstract Effectiveness of heparin versus 0.9% saline flushing to maintain patency of central venous catheters in adults Context: In the maintenance and optimization of central venous catheters (CVC) controversy persists about the recommended solution to maintain patency. This study aims to determine which solution (heparin or saline) are more effective in reducing the risk of occlusions, infections and other complications. Objective: To determine the effectiveness of the heparin flush versus 0.9% saline flush to maintain patency of CVC in adults. Methods: We perform a systematic review and meta-analysis following the principles proposed by the Cochrane Handbook. The critical analysis, extraction and synthesis of data were performed by two investigators separately and statistical analysis performed using RevMan 5.2.8. Results: We included six randomized controlled trials involving a total of 2278 patients. The results of the meta-analysis indicate no significant differences between the effectiveness of solutions to maintaining the CVC patency (RR=0.83, 95% CI=0.55-1.26; p=0.39). On the other hand, saline flushing does not constitute per se a factor that increases the risk of infection associated with the CVC. Conclusions: The saline solution is sufficient to maintain the permeability of the CVC preventing the risks associated with the administration of heparin.
Description
Keywords
Catéteres Cateterização venosa central Grau de desobstrução vascular Heparina Revisão Solução salina hipertónica Catheterization, central venous Catheters Heparin Review Saline solution, hypertonic Vascular patency