The Effectiveness of Normal Saline Versus Heparinised Saline in Maintaining Patency of Arterial Catheters: A Literature Review Ike Nesdia

Rahmawati 13th June 2013 Faculty of Nursing Airlangga University Surabaya, East Java-Indonesia nesdia@ymail.com Abstract Background: Arterial catheters are widely used for continuous blood pressure monitoring and blood sampling in intensive care units. In recent years, the selection of the fluid used in the arterial catheter between heparinised saline and normal saline has been a major topic in the health professions. Objective: This study literature through critical evaluation aimed to determine the effectiveness of normal saline as compared to heparinised saline in maintaining patency of the arterial catheters based on the duration and side effects of the use of flush solution. Method: The literatures were search through electronic databases on EBSCOhost databases MEDLINE and CINAHL, ProQuest, and ScienceDirect. Searches were limited to English language articles from January 2005 to June 2013. Results: A total of 5 research articles with randomized control trial design were included in this literature review. The evidence emerging from the literature indicates that both heparinised saline and normal saline has the same effectiveness in maintaining patency of arterial catheters. However, the use of heparin can cause negative effects such as heparin-induced thrombocytopenia, hypersensitivity reactions, and iatrogenic haemorrage. In addition, heparin can reduce the accuracy of measurements of aPTT and coagulation. Conclusions: Normal saline should be used instead of heparinised saline as a flush solution to maintain patency of arterial catheters to minimize the occurrence of side effects of heparin. Extra attention should be given by nurses to patients who select to use heparinised saline. Keyword: normal saline, heparinised saline, flush solution, arterial catheter, patency