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I lock my CVC with... 32 members have voted

  1. 1. What substance(s) do you use to lock central venous catheters temporarily not in use? (comments welcome!)

    • Heparin
      9
    • Saline solution
      6
    • Thrombolytic Agent
      0
    • Antibiotic Agent
      0
    • We do not lock catheters
      17

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We also run our central venous caths at min of 1ml/hr. We recently locked one side of a double lumen venous cath (as a physician preference), & found that it clotted even with regular flushes. 

I agree. No locks for CVCs. 

However, we have been able to keep them from clotting with saline at 0.8cc/h in very tiny babies in whom we really need to watch fluid intakes.

@gayle omansky @livesynapse Do you add heparin to your infusion solution (used at 0.8 /1.0 ml/h)?

The "Stockholm tradition" has been: hospitals on the northern side adds heparin, whereas those on the south side don't use heparin. I changed employer in 2014 and is now with a non-heparin NICU :) Since I came from a pro-heparin hospital I was a bit skeptical about not adding heparin to our low-flow saline in central catheters/lines. But, it seems to work equally well.

Our unit does not lock our CVL or PICC's. We run heparinized saline at 1.0ml/hr to keep them patent or we remove them as soon as they are longer needed.

  • 2 weeks later...
  • Author

Here is some literature on the subject:

http://www.ncbi.nlm.nih.gov/pubmed/27222450?dopt=Abstract

Quote

Int J Nurs Stud. 2016 Jul;59:51-9. Heparin versus 0.9% sodium chloride intermittent flushing for the prevention of occlusion in long term central venous catheters in infants and children: A systematic review. Bradford NK(1), Edwards RM(2), Chan RJ(3).

 

  • 4 weeks later...

Hi Stephan,

We still add Heparin to all our central line infusions at 0.5u/ml. This is a very interesting discussion & we may need to reconsider our practice. Thanks!

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