The Effects of Heparinized Normal Saline Flushing and  Prophylactic Enoxaparin on Central Venous Catheter  Thrombosis in PICU Hospitalized Pediatric

Maryam  Mohebbi; Effat  Hosseinali Beigi; Rezvaneh  Mohebbi; Maryam  Ghodsi

doi:10.18502/aacc.v10is2.17221

Maryam Mohebbi Department of Pediatrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Effat Hosseinali Beigi Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran.
Rezvaneh Mohebbi Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
Maryam Ghodsi Department of Pediatric Intensive Care Unit, School of Medicine. Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/aacc.v10is2.17221

Keywords: Heparin; Enoxaparin; Thrombosis; PICU; Central venous catheter; Pediatric

Abstract

Background: Central venous catheter (CVC) thrombosis is one of the most common complications of CVC that occurs in children and adults. Prevention of this blockage improves the treatment process and reduces treatment costs. Due to the lack of studies on preventive methods of CVC thrombosis, this study aimed to examine the effect of NS flushing heparinized and prophylactic dose of enoxaparin in prevention of CVC induced thrombosis in hospitalized patients in pediatric intensive care unit (PICU).

Methods: Eighty pediatrics with Central venous catheter admitted to the PICU enrolled in this trial and were divided into two groups as receiving heparinized normal saline was flushed every 8 hours under sterile conditions and receiving enoxaparin trough injection subcutaneously every 12 hours. The incidence of CVC-related thrombosis, diagnosed using color Doppler ultrasound of the vein containing the catheter was measured. Patients were monitored daily in terms of clinical symptoms related to thrombosis.

Results: There was no statistically significant difference in gender, age, anthropometric findings and vital sign as well as risk factors between two groups of the trial (P>0.05). Additionally, the finding showed a statistically significant relationship between major surgery (P=0.01) and heart disease (P=0.03) with symptomatic and asymptomatic thrombosis between the enoxaparin and heparinized normal saline groups. The rate of sepsis and bleeding were lower in enoxaparin group but it was not significant between study groups.

Conclusion: These findings indicate that enoxaparin may be considered as a clinical approach in thrombosis management and more clinical trials are needed.