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Evidence summaries

Heparin-Bonded Catheters for Prolonging the Patency of Central Venous Catheters in Children

Heparin-bonded catheters may reduce catheter-related infections and catheter colonization in children needing central venous catheters, but they might possibly not have effect on catheter-related thrombosis or duration of catheter patency. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 2 studies with a total of 287 children (aged 1 day to 16 years). There was no difference in the duration of catheter patency between heparin-bonded and non-heparin bonded catheters (median duration 7 days versus 6 days) reported in one study (n=200). There was no difference in the risk of catheter-related thrombosis (table T1). Data from one study revealed a statistically non-significant reduction in the risk of catheter occlusion. Catheter-related blood stream infections and catheter colonization were reduced in the heparin-bonded catheter group. The second study did not report on these outcomes. There was no significant difference in risk of thrombocytopenia after catheter placement.

Heparin-bonded central venous catheter compared with non-heparin bonded catheter in children

OutcomeRelative effect (95% CI)Assumed risk (Non heparin-bonded catheter)Corresponding risk (Heparin-bonded catheter; 95% CI)Participants (studies)
Catheter-related thrombosis at any time during catheter stayRR 0.34 (0.01 to 7.68)*175 per 100059 per 1000 (2 to 1 344)287 (2 studies)
Occlusion of catheter within one week of catheter insertionRR 0.06 (0.00 to 1.07)78 per 10005 per 1000 (0 to 83)200 (1 study)
Catheter-related blood stream infection and CVC-related colonizationRR 0.06 (0.01 to 0.41)184 per 100011 per 1000(2 to 75)200 (1 study)
Side effects: Thrombocytopenia after catheter insertionRR 0.73 (0.38 to 1.39)133 per 100097 per 1000(50 to 185)287 (2 studies)
*Statistical heterogeneity I2 =80%
Comment: The quality of evidence is downgraded by inconsistency (variability of results across studies) and by imprecise results (few patients and wide confidence intervals). Clinically important outcome of mortality was not reported. Further studies are needed to establish safety.