Alan Jobe, MD, PhD

Why has The Journal published yet another trial of heparin for maintenance of vascular catheters? The large randomized controlled trial in neonates reported by Klenner et al demonstrate that 0.5 Im/mL of heparin did prolong catheter use by a highly significant 7.4 hours.

There also were no cases of heparin-induced thrombocytopenia in this population of newborns.

Although heparin was not associated with increased bleeding or other complications in 145 infants, the authors think that the potential risk outweighs the statistically significant benefit, especially because there was no difference in numbers of catheter insertions per patient.

This paper reports a well-executed large randomized, controlled trial demonstrating a statistical difference that is judged by the authors not to be clinically significant when potential risks are compared with modest benefits.

The journel of Pediatrics Page 741

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