Low-dose heparin for prolonging the patency of peripheral intravenous catheters in adults a systematic review and meta-analysis
Bibliographic record
Abstract
Objective: To assess evidence from randomized controlled trials (RCTs) about the efficacy of low-dose heparin for prolonging patency of peripheral intravenous catheters in adults.Design: Systematic review and meta-analysis.Data Sources: We searched MEDLINE, EMBASE, CINAHL and Cochrane Central Register of Controlled Trials (CCTR) to identify studies up to July 6, 2012. Additional citations were retrieved from the bibliography of the selected articles. No language restrictions were placed.Eligibility criteria for selecting studies: The eligible studies were RCTs of low-dose heparin, used as continuous infusion or as intermittent flush, through peripheral intravenous catheter as compared to a control; and measured any one of the following outcomes: duration of catheter patency, occlusion rates or local site reactions such as thrombophlebitis.Results: Eight RCTs were identified (5 testing heparin as continuous infusion and 3 as intermittent flush). Catheters using heparin infusions had longer patency [Mean difference = 13.37 hours, 95%CI (3.37, 23.37), p=0.009], however, no difference in the duration of patency was noted from its use as intermittent flushing solution. Similarly, continuous infusion of heparin resulted in approximately 50% lower rates of infusion failures [rate ratio = 0.50, 95%CI (0.33, 0.76), p=0.001] and phlebitis [rate ratio = 0.47, 95%CI (0.31, 0.73), p<0.001] compared to no difference noted with its use as intermittent flushing solution. Few studies reported treatment related adverse events.Conclusion: Low-dose heparin used as continuous infusion in PIV catheters resulted in longer catheter patency with lesser episodes of infusion failures and phlebitis. Heparins use as intermittent flush solutions had no benefit. Keywords: Heparin, Patency, Infusion Failure, Phlebitis, Systematic Review
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.038 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.018 | 0.027 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".