NORMAL SALINE VERSUS HEPARIN FLUSH FOR MAINTAINING CENTRAL VENOUS CATHETER PATENCY DURING APHERESIS COLLECTION OF PERIPHERAL-BLOOD STEM-CELLS (PBSC)

Thrombotic occlusion is frequently a complication of central venous ca theters (CVCs). The original designers and producers of CVCs recommend ed heparin flush regimens to prevent thrombosis and maintain patency. This has become standard practice although no studies have demonstrate d a relationship between heparin flushing and reduction of catheter th rombosis. Many consider the routine use of heparin flushing innocuous. However, serious complications including drug interactions and hepari n induced thrombocytopenia and thrombosis syndrome (HITS) have been re ported in association with heparin flushing. Numerous studies comparin g heparin to saline flushing in peripheral devices suggest equal rates of thrombotic occlusions. The purpose of this study was to examine th e incidence of thrombotic occlusions in CVCs using heparin compared to saline flushing. The study involved 78 cancer patients undergoing aph eresis collection for peripheral blood stem cells; 29 received saline flushes and 49 received heparin (100 U/ml of saline) flushes. Study en dpoints included slow apheresis flow rate (<50ml/min), urokinase use f or thrombolysis, and radiographic evidence of catheter thrombosis. No significant differences were found for any endpoint between the two gr oups. These findings suggest saline may be as effective as heparin for maintaining patency of CVCs. (C) 1997 Elsevier Science Ltd.