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.
Keywords: COVID-19; Critical illness; Heparin; Thrombosis; Vascular access devices.
【저자키워드】 COVID-19, Critical illness, thrombosis, heparin, Vascular access devices., 【초록키워드】 coronavirus disease, Critical illness, Coronavirus disease 2019, Efficacy, protocol, thrombosis, risk, heparin, ICU, Coronavirus disease 2019 (COVID-19), Cohort, Critically ill, Characteristics, low dose, Patient, bleeding, Complication, age, incidence, assessment, critically ill patients, COVID-19 patients, episode of, bleeding risk, Vascular access devices, Vascular access, Critically ill patient, Observational cohort study, baseline characteristics, failure, cohorts, material, episode, systemic anticoagulation, significantly, clinically, median, groups, arterial line, with COVID-19, 【제목키워드】 protocol, low dose, COVID-19 patient, arterial line,