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In angiography, 2 to 5 units/mL of unfractionated heparin saline flush is used as a locking solution to prevent the clotting of blood in guidewires, sheaths, and catheters, thus preventing thrombus from dislodging from these devices into the circulatory system . [27] [28] Unfractionated heparin is used in hemodialysis.
The catheter is held in place by an adhesive dressing, suture, or staple which is covered by an occlusive dressing. Regular flushing with saline or a heparin-containing solution keeps the line open and prevents blood clots. There is no evidence that heparin is better than saline at preventing blood clots. [43]
Flushing with saline should be painless if the cannula is in its proper place, although if the saline is not warmed there may be a cold sensation running up the vein. A painful flush may indicate tissuing or phlebitis and is an indication that the cannula should be relocated. [1] Solutions other than normal saline may be used.
Heparin is an anticoagulant, and if used as a catheter lock solution it could leak into the blood circulation of the patient. Therefore it has been associated with catheter-related bleeding and heparin induced thrombocytopenia (HIT). [8] [9] Citrate catheter lock solutions are being used in three different concentrations – 4%, 30% and 46.7%.
Heparin-induced thrombocytopenia (HIT) is the development of thrombocytopenia (a low platelet count), due to the administration of various forms of heparin, an ...
In 2015, ICU Medical acquired Excelsior Medical Corporation, a manufacturer of healthcare devices used to disinfect and protect access into a patient's bloodstream. Acquired products included the SwabCap and SwabFlush, as well as pre-filled saline and heparin flush syringes.
Heparin is the most widely used intravenous clinical anticoagulant worldwide. [82] Heparin is a naturally occurring glycosaminoglycan. There are three major categories of heparin: unfractionated heparin (UFH), low molecular weight heparin (LMWH), and ultra-low-molecular weight heparin (ULMWH). [83]
The flush solution was designed to imitate intracellular fluid composition and contained mannitol as an impermeable ion to further prevent cell swelling. The osmolality of the solution was 430 mosmol/kg and its pH was 7.0 at 2 °C. The additives that had been used by Collins (dextrose, phenoxybenzamine, procaine and heparin) were omitted by Sacks.
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