***TASK***
the task is to simplify the input abstract of a biomedical literature

***INPUT***
the input is the abstract of a biomedical literature

***OUTPUT***
the output is the simplified abstract for the input abstract of a biomedical literature

***DOCUMENTATION***

***EXAMPLES***

Input: Three trials with a total of 245 participants were included in this review. The three trials directly compared the use of normal saline and heparin, however, between studies, all used different protocols for the standard and experimental arms with different concentrations of heparin and different frequency of flushes reported. In addition, not all studies reported on all outcomes. The quality of the evidence ranged from low to very low because there was no blinding, heterogeneity and inconsistency between studies was high and the confidence intervals were wide. CVC occlusion was assessed in all three trials (243 participants). We were able to pool the results of two trials for the outcomes of CVC occlusion and CVC-associated blood stream infection. The estimated rate ratio for CVC occlusion per 1000 catheter days between the normal saline and heparin group was 0.75 (95% CI 0.10 to 5.51, two studies, 229 participants, very low quality evidence). The estimated rate ratio for CVC-associated blood stream infection was 1.48 (95% CI 0.24 to 9.37, two studies, 231 participants; low quality evidence). The duration of catheter placement was reported to be similar between the two study arms, in one study (203 participants). The review found that there was not enough evidence to determine the effects of intermittent flushing of heparin versus normal saline to prevent occlusion in long term central venous catheters in infants and children. Ultimately, if this evidence were available, the development of evidenced-based clinical practice guidelines and consistency of practice would be facilitated.
Output:

This review included randomised controlled trials, (clinical studies where people were randomly assigned into one of two or more treatment groups), that compared the use of saline and heparin to prevent blockage, and other complications related to long term catheters. The evidence is current to April 2015. Two review authors independently reviewed the studies. Three studies with a total of 245 participants were included in the review. The three trials directly compared the use of saline and heparin, however, between studies, all were very different in the way they compared saline and heparin, with different concentrations of heparin and different frequency of flushes reported. We were able to combine the results of two studies; the analysis showed imprecise results for the blocking of catheters and blood stream infections between normal saline and heparin. One study reported the duration of catheter placement to be similar between the two study arms. The overall quality of the evidence ranged from low to very low. There was high risk of bias for blinding, there were differences between the studies methods and interventions, inconsistent results between the studies, and not all studies reported all outcomes of interest. We found there was not enough evidence to determine which solution, heparin or saline, is more effective for reducing complications. Further research is required and is likely to have an important impact in this area.