Heparin vs Normal Saline Locking for Prevention of Catheter Occlusion

Heparin vs Normal Saline Locking for Prevention of Catheter Occlusion

Heparin vs Normal Saline Locking for Prevention of Catheter Occlusion


Is intermittent locking with heparin or normal saline safer and more effective in the prevention of central venous catheter (CVC) occlusion?


A systematic review of 11 randomized controlled trials (RCTs).


CVCs commonly provide iv access for critically ill patients—yet they are not without risk. There is the possibility of thrombosis following CVC insertion, for example, which is a significant cause of morbidity and mortality, increasing the risk of blockage, infection, and pulmonary embolism. Consequently, when CVCs are not in use, intermittent locking (filling the lumens) with normal saline or unfractionated heparin is often used to maintain catheter patency. There are widespread differences in nursing practice, however, regarding locking frequency and the use of heparin versus normal saline. Thus, an examination of the effectiveness of heparin versus normal saline in intermittent CVC locking in adults is warranted.


A total of 11 RCTs of CVC locking in adults (a total of 2,392 participants) using heparin (any dose, with or without systemic drugs) versus normal saline were included in the review. There was heterogeneity across the trials due to variations in procedural methods and in heparin concentrations (10 to 5,000 IU/mL), the unit of analysis used (participant, catheter, line access), and time to follow-up (1 to 251.8 days).

Primary outcome measures were the occlusion of CVCs and the duration in days of catheter patency. Secondary outcome measures included episodes of CVC-related sepsis, mortality rates, hemorrhage anywhere in the body, heparin-induced thrombocytopenia (HIT), CVC-related thrombosis, and the abnormality of the coagulation profile.

Regarding the primary outcome, combined results of 10 studies showed fewer occlusions with heparin than with normal saline (very-low-quality evidence), but pooled results of six studies showed no clear differences between heparin and normal saline in the duration of catheter patency (low-quality evidence). Among the secondary outcomes, there were no clear differences between heparin and normal saline in episodes of CVC-related sepsis in two studies, mortality rates in three studies, hemorrhage anywhere in the body in four studies, HIT in three studies, and CVC-related thrombosis in three studies.

One study investigated the abnormality of coagulation profiles, finding significantly higher parameters in the heparin group for activated coagulation time and activated partial thromboplastin time. Prothrombin time was also elevated in the heparin group, but the difference between groups was not significant.


The results of this review suggest that, in adults, locking of CVCs with heparin may result in fewer occlusions than locking with normal saline, but the use of heparin may have little or no effect on the duration of CVC patency. These results should be interpreted with caution, however, because of the generally very low quality of the evidence.


Better-designed, large-scale RCTs are needed to definitively establish a net benefit of locking with heparin versus normal saline; these trials should also explore effectiveness in different patient groups, such as those under hemodialysis and those with hematologic malignancies. Occlusions and adverse events should be the focus of future trials, and assessment by type of line (such as dialysis/apheresis versus peripherally inserted central catheter or another type) is important.

López-Briz E, et al. Heparin versus 0.9% sodium chloride locking for prevention of occlusion in central venous catheters in adults Cochrane Database Syst Rev 2018 7 CD008462
Instant Nursing Papers
Hire a Nursing Expert
Pages (550 words)
Approximate price: -

Why Choose Instant Nursing Papers?

Quality Nursing Papers

We assist students in achieving the best top-grade in their nursing papers, and in compliance with the provided instructions. Have your nursing paper written with a certified specialist Ph.D., Bachelor's, and Master's graduates with many years of experience in academic writing.

Experts with Ph.d., MDs and DNP Holders

Our writers have acquired Ph.D., MDs and DNP credentials from world class institutions. Our writers can handle papers from any discipline and can handle over 100+ subjects.

Nursing Papers Cheap

We provide a great deal of student-friendly prices and professionalism with all our nursing essay writing services. Our paper writing services have a user-friendly interface and professional nursing academic assistance. We are committed to assisting all students with their nursing assignments and projects regardless of their academic level.

Fast Paper Delivery

Our writers follow a strict schedule to ensure papers are delivered before the deadline to enable our editors to proofread before the final delivery to our customers. We strictly observe the early delivery of assignments to meet our clients' deadlines.

Plagiarism-free Nursing Papers

Our expert nursing paper writers are dedicated to conducting thorough research and writing papers from scratch to deliver original papers. To avoid paper plagiarism, all orders go through steps of writing, editing, and proofreading.

24Hour Customer Help

Our customer support is available 24/7/365 to help clients and make their paper writing services easy to use. Our experienced support team is available to answer your queries any time, 24 hours a day.

Try it now!

Calculate the price of your order

We'll send you the first draft for approval by at
Total price:

How it works?

Follow these simple steps to get your paper done

Place your order

Fill in the order form and provide all details of your assignment.

Proceed with the payment

Choose the payment system that suits you most.

Receive the final file

Once your paper is ready, we will email it to you.

Our Nursing Papers Writing Service

We provide Nursing Assignment Services to Nursing students. Also, we are not limited to providing Nursing assignment help to students only. We also provide assignment help and solutions to community health nursing, Anatomy & Physiology, Microbiology, Biochemistry and Biophysics, and Nutrition & Dietetics.


Nursing Essays

Sit back, relax while our writers sort you out on your most daunting nursing essay queries on how to write a good nursing essay. We got you if you are looking for the best nursing essay services.


Nursing Projects

It is no doubt that qualifying for a nursing career is difficult and requires a series of tests. Most nursing students must put in a lot of work in their assignments and coursework. Instantnursingpapers.com will help you answer queries such as “who can write my nursing research paper?”.


Nursing Dissertation Help

Instantnursingpapers.com will save you the hustle of undergoing pressure or even depression while doing your nursing dissertation paper. Save yourself from all the long sleepless nights and pressure by working with our best nursing dissertation writing professionals.


Nursing Coursework Help

If you happen to hop into our site in search of nursing coursework help, look no further. We are the number one solution for the best nursing coursework assignments. Therefore, to complete the best APA nursing coursework, seek help from professional nursing coursework experts at instantnursingpapers.com