Heparina intermitente n？o é eficaz em impedir a retirada por obstru？？o de cateteres centrais inseridos perifericamente em recém-nascidos de termo e prematuros

objective: to evaluate the effectiveness of intermittent 10 u/ml heparin flushes in reducing the occlusion of peripherally inserted central catheters in neonates. methods: in this randomized, open-label, prospective, controlled study, neonates were allocated either to receive 0.5 ml flushes of heparin (group 1: n = 64) or saline (group 2: n = 69) every 4 hours. actions were taken to restore patency by using negative pressure (3-way stopcock method) in cases of occlusion. results: a total of 133 neonates were included. no significant intergroup difference was observed in the number of new occlusions (26 in group 1, or 31/1,000 catheter-days; 36 in group 2, or 36/1,000 catheter-days; p = 0.19). in group 1, 5 catheters had 9 recurrent obstructions after successful clearance maneuvers. in group 2, 19 catheters had 40 relapses (p < 0.0001), showing heparin's protective role against recurrence of obstruction (relative risk = 0.36). however, heparin failed to prevent catheter withdrawal due to permanent occlusion (3 catheters in group 1 and 8 in group 2; p = 0.24). conclusion: intermittent heparin is not effective for preventing the occlusion of peripherally inserted central catheters in neonates but reduces relapses when clearance maneuvers were successful