Coagulation-associated complications of indwelling arterial and central venous catheters during heparin prophylaxis - a prospective study

A prospective observational study was carried out to investigate complications of arterial and venous indwelling catheters. All patients of a mixed NICU/PICU admitted during a 12-month period were enrolled in this study with a stringent protocol of catheter prophylaxis, using heparin via continuous infusion in a dose of 100 IU/kg/day body weight or at least 100 IU/kg/day for each arterial and/or central venous catheter. Patients were regularly monitored for edema, thrombus, ischemia and catheter obstruction, i.e. complications amenable to heparinization. A total of 292 catheters in 130 patients were recorded. Patients' weight ranged between approximately 600 g to 10,000 g. Depending on the insertion site or type of catheter the frequency of complications was as follows: edema 0-12%; catheter obstruction 7-24%; ischemia 28-40%. No case of persistent thrombosis was detected. Conclusion A stringent protocol of heparinization leads to a low incidence of complications potentially amenable to anticoagulation.