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J Crit Care ; 60: 253-259, 2020 12.
Article in English | MEDLINE | ID: covidwho-739900

ABSTRACT

PURPOSE: Critically ill patients with Coronavirus Disease 2019 (COVID-19) have high rates of line thrombosis. Our objective was to examine the safety and efficacy of a low dose heparinized saline (LDHS) arterial line (a-line) patency protocol in this population. MATERIALS AND METHODS: In this observational cohort study, patients ≥18 years with COVID-19 admitted to an ICU at one institution from March 20-May 25, 2020 were divided into two cohorts. Pre-LDHS patients had an episode of a-line thrombosis between March 20-April 19. Post-LDHS patients had an episode of a-line thrombosis between April 20-May 25 and received an LDHS solution (10 units/h) through their a-line pressure bag. RESULTS: Forty-one patients (pre-LDHS) and 30 patients (post-LDHS) were identified. Baseline characteristics were similar between groups, including age (61 versus 54 years; p = 0.24), median Sequential Organ Failure Assessment score (6 versus 7; p = 0.67) and systemic anticoagulation (47% versus 32%; p = 0.32). Median duration of a-line patency was significantly longer in post-LDHS versus pre-LDHS patients (8.5 versus 2.9 days; p < 0.001). The incidence of bleeding complications was similar between cohorts (13% vs. 10%; p = 0.71). CONCLUSIONS: A LDHS protocol was associated with a clinically significant improvement in a-line patency duration in COVID-19 patients, without increased bleeding risk.


Subject(s)
COVID-19/physiopathology , Catheterization/instrumentation , Heparin/administration & dosage , Saline Solution/administration & dosage , Vascular Access Devices/adverse effects , Adult , Aged , COVID-19/complications , Catheterization/methods , Cohort Studies , Critical Illness , Female , Hemorrhage/complications , Hemorrhage/physiopathology , Humans , Male , Middle Aged , Risk Factors , Thrombosis/complications , Thrombosis/physiopathology , Treatment Outcome
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