heparin 5000unit/ML

[pineau]

I noticed that some dialysis units and oncology units use the heparin 5000units/ML. Is it recommended? Why not use the 10 or 100unit/ml solution?

Thanks for your help?

[IVRUS, BSN, RN]

Dialysis catheters have a larger internal diameter (ID) than other catheters and require a higher concentration of Heparin flush solution to maintain patency.

[Asystole RN]

there is a lot of controversy over the use of heparin in catheter locking. studies have proven inconclusive and meta-analysis have called into question the risk-benefit of using them. there is no current standard of practice on the use of heparin locks.

you will find in dialysis and oncology floors a surprising amount of diversity when it comes to locking solutions,some use various anticoagulants in various strengths and some use various antibiotics in various concentrations, some just use saline.

at a recent infusion seminar i attended theuse of heparin was called into question due to the fact it is a carbohydrate and has the potential to be a suitable growth medium for bacteria.

[Lynstat1]

Could you please tell me what infusion conference this was as I would love to read some presentations. I'm a Paeds nurse in Australia working primarily in Oncolgy and also have many questions surround the use of heparin for locking central lines whole minimsing the risk of infection and maintaining patency specifically in the paed population, and if a safer alternative has been found. I'm aware that there are clinical trials investigating the use of heparin, although I think the results were inconclusive.

[Asystole RN]

Could you please tell me what infusion conference this was as I would love to read some presentations. I'm a Paeds nurse in Australia working primarily in Oncolgy and also have many questions surround the use of heparin for locking central lines whole minimsing the risk of infection and maintaining patency specifically in the paed population, and if a safer alternative has been found. I'm aware that there are clinical trials investigating the use of heparin, although I think the results were inconclusive.

It was the Arizona Association of Vascular Access conference in June. I will find my notes for you.

The CDC used to recommend locking with heparin to decrease CLABSIs, the thought was that heparin decreased thrombi which in turn would decrease infection. Turns out the studies did not reflect this so it was dropped from the recommendations.

I actually did my Capstone project for my bachelor’s on heparin locking. There are many, many, many, many studies and meta-analysis done on heparin locking for many years, both here and in the United Kingdom. Turns out that there is no significant statistical correlation between heparin locking and occlusion rates nor with heparin locking and infection rates.

Not surprisingly if one looks to the hand-washing and port-disinfection studies but it appears that it does not matter what you use but rather how you use it. It was not the heparin that prevents occlusions but rather proper flushing technique.

I’ll see if I can dig up some of my research for you too.

[Lynstat1]

Thanks so much, that would be fantastic! I have considered a Masters/PhD in this area, focussing on the Paed population. From all I have read, it makes sense to me that it is the mechanical action of correct flushing technique (depending on the bung ie positive, negative or neutral) that maintains line patency