Page 50 - Ebook-Book JCMS 2025

Optimizing Arterial Line Maintenance in Critically Ill Covid-19
Patients: A Low-dose Heparinized Saline Strategy
Narisa Ajonsre*, Akarin Nimmannit, Auengporn Pituksung, Wisansaya Kampukhiaw, Patcharee Butsankot,
Mayura Vattanapongpisan, Ranistha Ratanarat
Faculty of Medicine, Siriraj Hospital, Mahidol University
*Corresponding Author E-mail: narisa.aro@mahidol.edu
Abstract
Objective: Maintaining arterial line patency is crucial for critically ill patients, especially those with
COVID-19 who are at increased risk of thrombosis. This study evaluates the effectiveness
of low-dose heparinized saline (LDHS) compared to standard normal saline (NSS) in
preventing arterial line occlusion.
Methods: A randomized controlled trial was conducted in a tertiary ICU with 61 critically ill COVID-19
patients requiring arterial line monitoring. Participants were randomly assigned to either
an LDHS group (2 units of heparin per 1 mL of NSS, n=31) or a control group receiving
standard NSS (n=30). Both groups received continuous pressure at 400 mmHg. Arterial line
patency was assessed using Kaplan-Meier survival analysis, while Pearson’s chi-square
test was applied for complications.
Results: Arterial line duration was similar between groups (LDHS: 6.7 days vs. NSS: 5.2 days,
p=0.66), with no significant differences in occlusion rates (87.1% vs. 93.3%, p=0.352).
Complication rates were also comparable (16.1% vs. 20.0%, p=0.337). The study found no
statistical advantage of LDHS over NSS in prolonging arterial line function.
Conclusions: LDHS did not demonstrate superior efficacy over NSS in arterial line maintenance under
standard ICU conditions. These findings suggest that routine use of heparinized saline may
not be necessary, and a focus on standardized pressure maintenance, monitoring, and care
protocols may be more impactful in optimizing arterial line patency. Future research should
explore individualized anticoagulation strategies based on patient-specific coagulation
profiles.
48 Joint Conference in Medical Sciences 2025