Dose:  0.25 to 1.0 ml/dose IV

Comments: Heparin lock flush solutions are intended to be used to maintain IV patency and not for anticoagulant therapy.  The 10 unit/ml solution should be used for maintaining central lines in infants less than 5 kilograms or for peripheral IVs in any sized infant.  See heparin comments for further information about heparin.

Toxicity:  Inadvertent heparinization causing hemorrhage or thrombocytopenia would be potential adverse effects if too much heparin would be administered.  See adverse effects associated with heparin.   There is one study that suggests the use of heparin in low-birth-weight infants may be associated with an increased risk of intraventricular hemorrhage (Lesko, NEJM, 314:1156, 1986). This was a retrospective chart review. In addition, the "case study" infants differed from controls in having lower mean birth weight (1098 vs. 1588), having more pneumothoraces, episodes of sepsis, episodes of acidosis, a diagnosis of HMD, treatment with volume expanders, and treatment with mechanical ventilation. All of the above would be expected to be associated with an increased incidence of IVH.

Preparation: Heparin Lock Flush is available from a variety of manufacturers in a 10 unit/ml concentration containing heparin 10 units/ml and sodium chloride 9 mg/ml.  It is supplied as floor stock in a 10 ml vial.   For larger infants (> 3 kilograms) who have a  Broviac catheter, a 100 unit/ml concentration is commercially available.  Both are stable at room temperature for 24 hours.

Compatibility: Precipitation during the administration of aminoglycosides through hep-locked catheters may occur if the device is not flushed with sterile water for injection or normal saline. See compatibility with heparin.