Efficacy of normal saline solution versus heparin solution for maintaining patency of peripheral intravenous catheters in children

Objectives: Literature reports support the use of normal saline solution for maintaining patency of peripheral intermittent intravenous infusion devices (PIID) in the adult population; however, there are limited data regarding this policy in the pediatric population. The purpose of this study was to establish the effects of heparin flush and saline solution flush solutions in maintaining patency of infusion devices in the pediatric population, and to establish cost-saving implications related to both procedures. The specific aims of the study included the following: (1) to determine the efficacy of normal saline solution flush for peripheral IV access devices for the pediatric population, and (2) to establish cost-saving implications related to normal saline solution versus heparin flush for PIIDs in terms of pharmacy costs and costs related to nursing time. Methods: The study was a prospective, randomized, double-blind controlled trial of flushing solutions. The control group (n = 77) received 3 ml of a 10 units heparin/ml normal saline solution IV flush. The experimental group (n = 73) received 3 ml of normal saline solution only for the IV flush. Routine hospital procedure for flushing was followed during the study period. Results: Descriptive and correlation statistics were used to analyze the data; χ2, t test, and analysis of variance were calculated. There were no significant differences between the two groups for demographics or complications. Annual cost savings were computed for both procedures with an estimated annual savings of nursing time and unit cost of solutions equaling $27,594. The savings per procedure was estimated at $9.45. Discussion: This study provided support for the efficacy of normal saline solution as an alternative to heparin solutions for the maintenance of peripheral IV devices. Implications include elimination of risks associated with heparin (drug incompatibilities, thrombosis syndrome, hypersensitivity reactions, local tissue damage, and iatrogenic hemorrhage); decreased potential for infection associated with breaks in the integrity of the IV system; substantial money savings as a result of the change to normal saline solution realized by the patient and the institution; and decreased nursing time. By simplifying the procedure, nurses have more time to provide aspects of nursing care to patients