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Abstract

Introduzione. Prevenire le occlusioni dei dispositivi di accesso venoso centrale (DAVC) è cruciale per la continuití  e qualití  delle cure. Vi è ampio consenso sulla necessití  di eseguire un periodico lavaggio del lume del presidio per assicurarne la pervietí . Le soluzioni più utilizzate sono la soluzione con eparina (SE) e la soluzione fisiologica (NaCl 0.9% - SF). Sussistono ancora pareri controversi sull'efficacia della SE rispetto alla SF. Obiettivo. Valutare l'efficacia della SE rispetto alla SF per prevenire le occlusioni nei DAVC.

Metodi. E' stata implementata il 4 aprile 2017 una strategia di ricerca su quattro database elettronici (The Cochrane Library, Medline, Embase, CINAHL). I record restituiti sono stati analizzati in modo indipendente; quelli rispettanti i criteri di inclusione sono stati reperiti in full text. Sono state incluse revisioni sistematiche di RCT o studi quasi sperimentali che hanno confrontato l'utilizzo della SE con la SF. La valutazione di qualití  delle revisioni è avvenuta con la AMSTAR checklist.

Risultati. Sette revisioni sistematiche di qualití  moderata-alta hanno rispettato i criteri di inclusione. La SE non è stata superiore alla SF nel prevenire le occlusioni dei DAVC.

Discussione. Le revisioni incluse sono state di alta qualití  metodologica; l'eterogeneití  statistica fra RCT è stata bassa mentre l'eterogeneití  clinica e metodologica è stata elevata. Conclusioni. La SE non è stata più efficace della SF per prevenire le occlusioni dei DAVC. In attesa di studi di qualití  migliore indirizzati alla valutazione della procedura di gestione complessiva dei DAVC, sembra ragionevole consigliare l'utilizzo della SF.

Parole chiave. sinossi, efficacia, eparina non frazionata, soluzione fisiologica, dispositivo di accesso venoso centrale, occlusione 

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Synopses of systematic reviews on effectiveness of heparin to prevent occlusion in central venous access devices

ABSTRACT

Introduction. Prevention of central venous access devices (CVAD) occlusion is crucial to the continuity and quality of care. There is wide consensus on the need to carry out a periodic flushing of the lumen of device in order to ensure its patency. The most commonly used solutions are the heparin solution (HS) and the physiological solution (NaCl 0.9% - PS). There are still controversial opinions on HS's effectiveness over PS. Objective. To evaluate the effectiveness of HS compared to PS to prevent occlusion in CVAD.

Methods. A search strategy on four electronic databases (The Cochrane Library, Medline, Embase, CINAHL) was implemented on April 4, 2017. Records returned were independently analyzed; those complying with inclusion criteria were found in full text. They've been included systematic reviews of RCT or quasi-experimental studies that have compared the use of HS with PS. The quality assessment of reviews was done with AMSTAR checklist.

Results. Seven moderate-high quality systematic reviews met inclusion criteria. HS is was not superior to PS in preventing CVAD occlusions.

Discussion. Reviews included were of high quality methodological. The statistical heterogeneity between RCT was low while the clinical and methodological heterogeneity was high. Conclusions. HS was no longer effective than PS to prevent CVAD occlusions. Waiting for better quality studies to evaluate the overall DAVC management process, it seems reasonable to recommend using PS.

Keyword. Synopsis, effectiveness, non-fractionef heparin, physiological solution, central venous access device, occlusion

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Come citare
Re, L. G., Fusetti, V., & Lusignani, M. (2018). Sinossi di revisioni sistematiche sull’efficacia dell’eparina per prevenire le occlusioni nei dispositivi di accesso venoso centrale. PROFESSIONI INFERMIERISTICHE, 71(2). Recuperato da https://profinf.net/pro3/index.php/IN/article/view/500
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