TKO/KVO vs. Saline Lock

Specialties NICU

Published

Hello, I am wondering if any nurseries/units are using TKO rates instead of saline lock? If so, what is your TKO rate for newborns? I appreciate any thoughts of TKO vs. Saline Lock for longevity of IV sites in newborns. Thanks!

Specializes in Level II & III NICU, Mother-Baby Unit.

If it's a PIV we generally heparin lock them. Lately we had a big baby who had difficult IV access and needed 10 days of antibiotics. Our neonatologist placed a PICC line and we ran UAC fluids (1/2 normal saline with 1 unit Heparin/mL) at 0.4 mL/hr until the antibiotics were finished being given then the PICC was discontinued. I have noticed over the years that heparin locks don't seem to last nearly as long as PIVs that have a little fluid running though them. I wonder if the fluid dilutes the medications and helps cause less irritation to the vein from the medications or maybe the fluid running helps in some other way. Wish I knew the answer. By the way, we heparin lock our PIVs and flush every 3-4 hours with a 2 unit/ml heparin solution prefilled syringe from our pharmacy.

Specializes in NICU, PICU, PACU.

We saline lock our PIV's, our piccs and 2nd lumen of our uvc's we run hep saline thru at 0.5ml/hr. We quit using heparin on our PIV's about 6 or 7 years ago since EBP showed no difference in the longevity of the line.

Saline lock PIV's with every cares. PICCS vary from D5, D10, 1/2NS and NS with 1u/ml heparin depending on the baby, little ones we run it at 0.5ml/hr, bigger ones we run @ 1ml/hr. We hep lock broviacs q12 hrs

Specializes in NICU.

We saline lock our PIVs and flush them with NSS every 6 hours.

For PICCs, we pull them when we are infusing into the primary lumen

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