Effectiveness of Heparin during Long-Term Tocolysis

Objective. Drip infusion during long-term tocolysis causes mechanical and infectious vasculitis and increases the frequency of peripheral venous catheter exchange (PVC), thereby placing a burden on patients. Our study aim is to confirm whether heparin ameliorates pain due to vasculitis during long-term tocolysis and reduces the frequency of peripheral venous catheter exchange. Design. Prospective study. Setting and Sample. All the patients requiring admission because of the presence of uterine contraction or progressive cervical dilatation from August 2009 to June 2011 at Juntendo University in Japan. Methods. Heparin was used for patients at the time the total number of peripheral venous catheter exchanges exceeded 5 in two weeks, and we evaluated whether heparin reduced the frequency of peripheral venous catheter exchange and improved the visual analog scale (VAS) for patients. The main outcome measures frequency of PVC exchange and VAS. Results. This study demonstrated that heparin reduced the frequency of peripheral venous catheter exchange (P = 0.0069) and VAS (P = 0.042). No side effects were noted. Conclusion. Heparin could satisfy patients during long-term tocolysis in terms of ameliorating pain due to vasculitis and reducing the PVC exchange frequency.

[1]  J. Gallagher,et al.  Size‐fractionated heparins have differential effects on human neutrophil function in vitro , 2007, British journal of pharmacology.

[2]  A. Daneman,et al.  A Randomized, Controlled Trial of Heparin Versus Placebo Infusion to Prolong the Usability of Peripherally Placed Percutaneous Central Venous Catheters (PCVCs) in Neonates: The HIP (Heparin Infusion for PCVC) Study , 2007, Pediatrics.

[3]  A. Sav,et al.  Effect of a Low Molecular Weight Heparin Molecule, Dalteparin, on Cellular Apoptosis and Inflammatory Process in an Incisional Wound-Healing Model , 2007, Surgery Today.

[4]  K. Hassell.  The management of patients with heparin-induced thrombocytopenia who require anticoagulant therapy. , 2005, Chest.

[5]  I. Bates,et al.  The efficacy of heparin in maintaining peripheral infusions in neonates , 1995, European Journal of Pediatrics.

[6]  T. Warkentin.  Heparin-induced thrombocytopenia: diagnosis and management. , 2004, Circulation.

[7]  A. Golichowski,et al.  Treatment of heparin induced thrombocytopenia and thrombosis during the first trimester of pregnancy , 2004, Journal of thrombosis and haemostasis : JTH.

[8]  P. Woolley,et al.  A Phase I trial of spirogermanium administered on a continuous infusion schedule , 2004, Investigational New Drugs.

[9]  P. Shah,et al.  Heparin for prolonging peripheral intravenous catheter use in neonates. , 2005, The Cochrane database of systematic reviews.

[10]  N. Sakuragi,et al.  Thromboprophylaxis with low molecular weight heparin in thrombophilia‐complicated pregnancy , 2002, The journal of obstetrics and gynaecology research.

[11]  J. Nelson,et al.  Management of heparin allergy in pregnancy , 2001, American journal of hematology.

[12]  V. Shah,et al.  Continuous heparin infusion to prevent thrombosis and catheter occlusion in neonates with peripherally placed percutaneous central venous catheters. , 2001, The Cochrane database of systematic reviews.

[13]  F. Fabris,et al.  Heparin-induced thrombocytopenia. , 2000, Haematologica.

[14]  D. Cook,et al.  Benefit of heparin in peripheral venous and arterial catheters: systematic review and meta-analysis of randomised controlled trials , 1998, British medical journal.

[15]  O. Larm,et al.  Surface heparinization of central venous catheters reduces microbial colonization in vitro and in vivo: results from a prospective, randomized trial. , 1996, Critical care medicine.

[16]  M. Pollack,et al.  Catheter-related thrombosis in critically ill children: comparison of catheters with and without heparin bonding. , 1995, The Journal of pediatrics.

[17]  B. Schmidt,et al.  Neonatal thrombotic disease: prevention, diagnosis, and treatment. , 1988, The Journal of pediatrics.

[18]  D. Cochran,et al.  Effect of heparin on vascular smooth muscle cells. I. Cell metabolism , 1985, Journal of cellular physiology.

[19]  L. Kager,et al.  Reduction of catheter-associated thrombosis in parenteral nutrition by intravenous heparin therapy. , 1982, Archives of surgery.