Heparin saline ratio for cvc
Reading File
Finding Sources
Finding Sources
Reading File
Reading File
Here is a concise summary of the evidence on heparin vs. saline flushing for CVCs:
Heparin vs. Saline for CVC Flushing
Key Evidence
Saline is equivalent to heparin for patency:
"Flushing the CVC with saline has proved as beneficial as flushing with heparin for preventing catheter occlusion by a thrombus." — Sleisenger and Fordtran's Gastrointestinal and Liver Disease
This means normal saline (0.9% NaCl) alone is sufficient to maintain CVC patency in most settings — there is no proven advantage to adding heparin for routine flushing.
When Heparin Is Still Used
Despite equivalent patency outcomes, heparin locks are still used in certain contexts:
| Situation | Practice |
|---|---|
| Standard CVCs (Hickman, Broviac, PICCs) | Heparin lock (10–100 units/mL) historically used; saline increasingly preferred |
| Groshong catheter | Saline only — the one-way slit valve design makes heparin unnecessary |
| Implanted ports (e.g., Port-A-Cath) | Heparin 100 units/mL commonly used for periodic flushing when not in use |
| PN solutions | Heparin 1000 units/L added to each bag to reduce subclinical thrombus formation and catheter sepsis risk |
— Roberts and Hedges' Clinical Procedures in Emergency Medicine; Sleisenger and Fordtran's
Common Heparin Concentrations (Where Used)
- Heparin lock flush: 10–100 units/mL
- PN bags: 1000 units/L (1 unit/mL)
- Groshong / valved catheters: saline only (no heparin needed)
Practical Takeaway
Current evidence supports normal saline as the first-line flush for most CVCs. Heparin locks remain in use for implanted ports and institutional protocols, but do not offer additional patency benefit over saline for standard CVCs. Always check your institutional protocol, as practices vary.
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