{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T12:16:03Z","timestamp":1789820163543,"version":"4.0.1"},"reference-count":18,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Arch Dis Child"],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Recent evidence supports the use of normal saline flushes in place of heparin to maintain the patency of peripheral intravenous locks (IVLs); however, there are no data regarding the recommended flush frequency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design<\/jats:title><jats:p>This was an open, non-inferiority, randomised controlled trial. Children with IVLs, aged 1\u201317\u2005years, were randomly assigned to receive saline flushing every 12\u2005h (group A) or every 24\u2005h (group B). The main outcome was the maintenance of catheter patency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four hundred patients were randomised; 198 subjects were analysed in the 12\u2005h group and 199 in the 24\u2005h group (three patients were lost at follow-up). Occlusion occurred in 15 children (7.6%) in group A versus 9 (4.5%) in group B (p=0.21). The difference in catheter patency was +3.1% in favour of the 24\u2005h group (95% CI \u22121.6% to 7.7%), showing the non-inferiority of the 24\u2005h procedure (the non-inferiority margin was set at \u22124%). Catheter-related complications were not different between the two groups (12.1% in group A vs 9.5% in group B; p=0.42).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A flushing procedure with one flush per day allows maintenance of catheter patency without an increase in catheter-related complications. We propose a simplification of the flushing procedure with only one flush per day, thereby reducing costs (materials use and nursing time), labour and unnecessary manipulation of the catheters which can cause distress in younger children and their parents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p>The study is registered in the international database ClinicalTrial.gov under registration number <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT02221024\">NCT02221024<\/jats:ext-link>.<\/jats:p><\/jats:sec>","DOI":"10.1136\/archdischild-2014-307478","type":"journal-article","created":{"date-parts":[[2015,1,15]],"date-time":"2015-01-15T06:53:54Z","timestamp":1421304834000},"page":"700-703","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Normal saline flushes performed once daily maintain peripheral intravenous catheter patency: a randomised controlled trial"],"prefix":"10.1136","volume":"100","clinical-trial-number":[{"clinical-trial-number":"nct02221024","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct02221024","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Silvana","family":"Schreiber","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Zanchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Ronfani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Delise","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Corbelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosamaria","family":"Bortoluzzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Taddio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Egidio","family":"Barbi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2015,1,14]]},"reference":[{"key":"key-10.1136\/archdischild-2014-307478-1","first-page":"1","article-title":"Management of peripheral intravascular devices","volume":"12","author":"The Joanna Briggs Institute","year":"2008","journal-title":"Best Pract Evid Based Pract Inform Sheets Health Prof"},{"key":"key-10.1136\/archdischild-2014-307478-2","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1097\/01.NAN.0000317704.03415.b9","article-title":"Peripheral IVs: factors affecting complications and patency\u2013a randomized controlled trial","volume":"31","author":"Tripathi","year":"2008","journal-title":"J Infus Nurs"},{"key":"key-10.1136\/archdischild-2014-307478-3","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1111\/j.1440-172X.2006.00607.x","article-title":"A randomized controlled trial for maintaining peripheral intravenous lock in children","volume":"13","author":"Mok","year":"2007","journal-title":"Int J Nurs Pract"},{"key":"key-10.1136\/archdischild-2014-307478-4","doi-asserted-by":"crossref","first-page":"2677","DOI":"10.1111\/j.1365-2648.2011.05718.x","article-title":"Effectiveness of heparin solution versus normal saline in maintaining patency of intravenous locks in neonates: a double blind randomized controlled study","volume":"67","author":"Arnts","year":"2011","journal-title":"J Adv Nurs"},{"key":"key-10.1136\/archdischild-2014-307478-5","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1097\/ANC.0b013e31821bab61","article-title":"Heparinized saline vs normal saline for maintenance of intravenous access in neonates: an evidence-based practice change","volume":"11","author":"Cook","year":"2011","journal-title":"Adv Neonatal Care"},{"key":"key-10.1136\/archdischild-2014-307478-6","doi-asserted-by":"crossref","first-page":"e864","DOI":"10.1542\/peds.2012-2403","article-title":"Low-dose heparin use and the patency of peripheral IV catheters in children: a systematic review","volume":"131","author":"Kumar","year":"2013","journal-title":"Pediatrics"},{"issue":"(4)","key":"key-10.1136\/archdischild-2014-307478-7","first-page":"CD002774","article-title":"Heparin for prolonging peripheral intravenous catheter use in neonates","author":"Shah","year":"2005","journal-title":"Cochrane Database Syst Rev"},{"key":"key-10.1136\/archdischild-2014-307478-8","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/S0099-1767(97)90216-6","article-title":"Efficacy of normal saline solution versus heparin solution for maintaining patency of peripheral intravenous catheters in children","volume":"23","author":"LeDuc","year":"1997","journal-title":"J Emerg Nurs"},{"issue":"(Suppl 1","key":"key-10.1136\/archdischild-2014-307478-9","first-page":"S1","article-title":"Infusion nursing standards of practice","volume":"29","author":"Infusion Nurses Society","year":"2006","journal-title":"J Infus Nurs"},{"key":"key-10.1136\/archdischild-2014-307478-10","first-page":"405","article-title":"Heparin vs. saline for peripheral IV locks in children","volume":"19","author":"Kleiber","year":"1993","journal-title":"Pediatr Nurs"},{"key":"key-10.1136\/archdischild-2014-307478-11","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1097\/00005721-199303000-00005","article-title":"Heparinized saline or normal saline as a flush solution in intermittent intravenous lines in infants and children","volume":"18","author":"McMullen","year":"1993","journal-title":"MCN Am J Matern Child Nurs"},{"key":"key-10.1136\/archdischild-2014-307478-12","article-title":"Evidenced based practice: study on the efficacy of normal saline versus heparin saline flushing for maintaining patency of intravenous instopper in pediatric patients (Abstract)","author":"Tang"},{"key":"key-10.1136\/archdischild-2014-307478-13","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1093\/ajhp\/55.6.570","article-title":"0.9% sodium chloride injection with and without heparin for maintaining peripheral indwelling intermittent-infusion devices in infants","volume":"55","author":"Nelson","year":"1998","journal-title":"Am J Health Syst Pharm"},{"key":"key-10.1136\/archdischild-2014-307478-14","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1111\/j.1744-6155.1998.tb00216.x","article-title":"A randomized trial of heparin and saline for maintaining intravenous locks in neonates","volume":"3","author":"Heilskov","year":"1998","journal-title":"J Soc Pediatr Nurs"},{"key":"key-10.1136\/archdischild-2014-307478-15","first-page":"43","article-title":"Heparin vs saline for intermittent intravenous device maintenance in neonates","volume":"15","author":"Kotter","year":"1996","journal-title":"Neonatal Netw"},{"key":"key-10.1136\/archdischild-2014-307478-16","first-page":"383","article-title":"Double blind comparison of heparin and saline flush solutions in maintenance of peripheral infusion devices","volume":"21","author":"Gyr","year":"1995","journal-title":"Pediatr Nurs"},{"key":"key-10.1136\/archdischild-2014-307478-17","first-page":"211","article-title":"Intravenous lock patency in children: dilute heparin versus saline","volume":"2","author":"Beecroft","year":"1997","journal-title":"J Pediatr Pharm Pract"},{"key":"key-10.1136\/archdischild-2014-307478-18","first-page":"142","article-title":"Patency of 24-gauge peripheral intermittent infusion devices: a comparison of heparin and saline flush solutions","volume":"24","author":"Mudge","year":"1998","journal-title":"Pediatr Nurs"}],"container-title":["Archives of Disease in Childhood"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/archdischild-2014-307478","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,26]],"date-time":"2020-09-26T10:52:30Z","timestamp":1601117550000},"score":1,"resource":{"primary":{"URL":"https:\/\/adc.bmj.com\/lookup\/doi\/10.1136\/archdischild-2014-307478"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,1,14]]},"references-count":18,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2015,6,19]]},"published-print":{"date-parts":[[2015,7]]}},"alternative-id":["10.1136\/archdischild-2014-307478"],"URL":"https:\/\/doi.org\/10.1136\/archdischild-2014-307478","relation":{},"ISSN":["0003-9888","1468-2044"],"issn-type":[{"value":"0003-9888","type":"print"},{"value":"1468-2044","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,1,14]]}}}