Evidence map›Paper›PMID 28063456›Full record

SynthesisCritical care (London, England)2017

Normal saline versus heparin for patency of central venous catheters in adult patients - a systematic review and meta-analysis.

Lei Zhong, Hai-Li Wang, Bo Xu, Yao Yuan, Xin Wang, Ying-Ying Zhang, Li Ji, Zi-Mu Pan, Zhan-Sheng Hu

Registry-linked trialOpen access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Critical care (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04054128 (Bicarbonate vs Heparin Catheter Lock in Chronic Hemodialysis Patients), which is not on this map. Cited by 26 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 4 pooled it
12.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04054128 phase4unknown statusnot on this mapstarted 2019, after this paper: background citation

Bicarbonate vs Heparin Catheter Lock in Chronic Hemodialysis Patients

TypeinterventionalSponsorHospital General "Dr. Miguel Silva" de MoreliaRan2019 to 2020Enrolled60ConditionsEnd Stage Renal Disease, Vascular Access Complication, Catheter Complications, Hemodialysis Access FailureArmsSodium Bicarbonate 7.5% Injection, Heparin Sodium, 1000 Units/mL Injectable Solution 1
3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 4 syntheses or guidelines pooled it, 79 citations in OpenAlex.

  1. Pooled it
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  5. Trial
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  8. Review
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  13. Autoimmune Heparin-Induced Thrombocytopenia.Journal of clinical medicine · 2023
    Review
  14. Review
  15. Article
  16. Article
  17. Canadian oncology nursing journal = Revue canadienne de nursing oncologique · 2022
    Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Lei ZhongDepartment of Intensive Care Units, The First Affiliated Hospital of Jinzhou Medical University, No. 2, The Fifth Section of Renmin Street, Guta, Jinzhou, 121000, Liaoning, China.
Hai-Li WangDepartment of Obstetrics and Gynaecology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, 121000, Liaoning, China.
Bo XuDepartment of Intensive Care Units, The First Affiliated Hospital of Jinzhou Medical University, No. 2, The Fifth Section of Renmin Street, Guta, Jinzhou, 121000, Liaoning, China.
Yao YuanJinzhou Medical University, Jinzhou, 121000, Liaoning Province, China.
Xin WangXinxiang Medical University, Xinxiang, 453000, Henan Province, China.
Ying-Ying ZhangDepartment of Intensive Care Units, The First Affiliated Hospital of Jinzhou Medical University, No. 2, The Fifth Section of Renmin Street, Guta, Jinzhou, 121000, Liaoning, China.
Li JiDepartment of Intensive Care Units, The First Affiliated Hospital of Jinzhou Medical University, No. 2, The Fifth Section of Renmin Street, Guta, Jinzhou, 121000, Liaoning, China.
Zi-Mu PanDepartment of Intensive Care Units, The First Affiliated Hospital of Jinzhou Medical University, No. 2, The Fifth Section of Renmin Street, Guta, Jinzhou, 121000, Liaoning, China.
Zhan-Sheng HuDepartment of Intensive Care Units, The First Affiliated Hospital of Jinzhou Medical University, No. 2, The Fifth Section of Renmin Street, Guta, Jinzhou, 121000, Liaoning, China. icugroup@sina.com.
Jinzhou Medical University · CNXinxiang Medical University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHeparin saline (HS) is theoretically superior to normal saline (NS) for maintaining the patency of central venous catheters (CVCs), but the comparative efficacy of them remains controversial. The aim of this systematic review and meta-analysis was to assess the efficacy of NS versus HS in the maintenance of the patency of CVCs in adult patients.

methodsWe searched PubMed, Embase and the Cochrane library databases. Randomized controlled trials (RCTs) evaluating the use of NS vs. HS to maintain the permeability of CVCs among adult patients were included in our meta-analysis. References of relevant papers were reviewed manually. No language restriction was applied. Non-human studies were excluded. Pooled relative risk (RR) was calculated using a Mantel-Haenszel random-effects model. We also performed subgroup analysis examining the effect of the duration of catheter placement on the outcome. All statistical tests were two-sided using a significance level of 0.05.

resultsTen RCTs involving 7875 subjects (with analysis at patient, catheter, lumen and line access level) were included in this meta-analysis. Whether in terms of pooled or local analysis (RR with 95% confidence interval spans 1), NS can be equally, if not more effective, in keeping the CVCs open. Of studies reporting secondary outcomes (maneuver needed, heparin-induced thrombocytopenia, haemorrhage, central venous thrombosis and catheter-related bloodstream infection), heparinised saline was shown not to be superior to non-heparinised solution. Subgroup analysis in patients with short vs long term CVC placement was consistent with the main outcome partly and in particular for maintenance of catheter patency in patients with a long-term placement i.e. >30 days, the RR was 0.97 (n = 6589; 95% CI = 0.76 to 1.23; P = 0.796). However, for patients in whom the catheter was in place for <30 days, the RR was 1.52 (n = 1286; 95% CI = 1.02 to 2.27; P = 0.041).

conclusionsBased on the results of this meta-analysis, HS is not superior to NS in reducing CVCs occlusion. But in the short term, the use of HS is slightly superior to NS for flushing catheters from a statistical point of view.

Indexed as

Central Venous CathetersAdultCatheter ObstructionHeparinHumansSodium ChlorideTherapeutic IrrigationThrombosisHeparinSodium ChlorideCentral venous cathetersHeparinNormal salineOcclusion

Identifiers

PMID28063456
PMCPMC5219914
OpenAlexW2569258052

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.