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CRITICAL CARE AND TRAUMA

A Comparison of the Efficacy of Heparinized and Nonheparinized Solutions for Maintenance of Perioperative Radial Arterial Catheter Patency and Subsequent Occlusion

Department of Anesthesiology and Reanimation, Dokuz Eylul University, Izmir, Turkey

Address correspondence and reprint requests to Dr. Binnur Erdalkiran Tuncali, Huzur mah. Sumbul sok. No:42/11, Narlidere Izmir, Turkey. Address e-mail to binnur.tuncali{at}deu.edu.tr.

In a randomized, double-blind, controlled study, we compared heparinized and nonheparinized infusions for the maintenance of perioperative arterial catheter patency and the incidence of subsequent radial arterial occlusion. Two-hundred patients were randomized into 2 groups to receive heparinized (group H, n = 100) or nonheparinized (group S, n = 100) flush solutions. Radial and ulnar blood flows were assessed using Doppler probe and pulse oximetry before, just after, and 24 h after decannulation by the same investigator. The cannulation site was examined for complications such as hematoma, nerve injury, and infection. The mean duration of cannulations was 378 ± 159.0 min in group H and 332 ± 154.6 min in group S. The mean number of corrective interventions caused by dampening of the pressure wave (mean number of positional changes [group S, 1.5 ± 2.0; group H, 1.4 ± 3.8] and mean number of manual flushes [group S, 1.3 ± 1.7; group H, 1.2 ± 1.2]) was not significantly different in both groups. After decannulation, partial or total occlusion developed in 20 group H patients and 16 group S patients (not significant). The incidence of occlusion was correlated to the presence of hematoma at the puncture site after decannulation (P = 0.013), long duration of cannulation (P = 0.04), and age <65 yr (P = 0.009). In conclusion, there is no significant difference between heparinized and nonheparinized flush solutions for the maintenance of perioperative radial artery catheter patency.

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