Critical Care Nursing
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Browsing Critical Care Nursing by Author "Enas Abed Al-Kareem Taleb"
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- ItemHEPARINIZATION VERSUS SALINE FLUSH OF CENTRAL VENOUS CATHETER (CVC) LUMENS IN CRITICAL CARE UNIT PATIENTS IN LARGE TERTIARY HOSPITAL(2022-12-28) Enas Abed Al-Kareem TalebBackground: The central venous catheter (cvc) has a risk of complications, including catheter thrombosis. To prevent this thrombosis, flushing of CVC is needed. There are several methods for flushing (CVC): the first one is heparin with saline after each use while the second method is saline flush. Objectives: To assess the effectiveness of intermittent flushing of normal saline versus heparin to prevent occlusion in long‐term central venous catheters among adult patients in the ICU of Large Tertiary Hospital. Methodology: Randomize Control trial (RCT) design was used in this study. The sample was selected from all patients who were admitted to the ICU department of An-Najah Hospital during the period of August 2020 to October 2020 and have CVC. Patients were selected in a convenience method, and 53 patients agreed to participate in the study. These patients were distributed randomly into two groups; an experimental group (n =26 patients) and a control group (n =27 patients). The experimental group was given flush (a combination of heparin and normal saline), and the control group was given a flush with (normal saline only). To monitor the two procedures, the researcher developed a Check list that included demographic data, lab values, hemodynamic, Patency and complication of CVC. The researcher was able to fill the checklist for every patient. Results: The results showed that coagulation profile (PTT) was less than 35 seconds at admission for experimental group (76.9%) versus control group that got (48.1%) at significant level of P value; (0.031). For easy patency of CVC, the experimental group got (69.2%) which was higher than control group; (37%) while in moderate and difficult patency, the experimental group had less value than the control group (40.7% VS 26.9) and (22.2% VS 3.8%) respectively, at significant level of P value of (0.035). No differences were noticed between the experimental group and the control group in occurrence of complication such as discharge color around CVC, Swab culture result, Oozing from the CVC site. The study showed that dressing daily was for the control group (96.3%) while it was weekly for the experimental group (76.9%). Conclusion: There was a significant difference in the coagulation profile only at admission (p value is 0.031) and significant in patency (p value is 0.035). CVC of the experimental group (combination N/S with heparin group) showed easier patency than the control group (normal saline group), while there was no significant difference in the complications between the two groups. Recommendation: Nurses working at the ICU units should be oriented about the use of normal saline (0.9%) alone without heparin to flush CVC for adult patients. The benefit of this method should be emphasized as to decrease cost of heparin use, and to avoid any adverse effects with heparin use Keywords: Central Venous Catheter (CVC), Heparin, Normal Saline (NS),