Flushing hemodynamic catheters is essential to maintain patency and therefore ensure accurate hemodynamic measurements, arterial blood sampling, and cardiac output determinations. Patency of hemodynamic catheters has been maintained for decades in critical care settings with pressurized infusions of heparinized saline to prevent clots from forming around or within catheters. Recently, the use of heparinized saline is being questioned because of the desire to eliminate as much heparin exposure as possible and thereby minimize risks such as heparin-induced thrombocytopenia (HIT).

With an estimated incidence of 1% to 3%, HIT is a rare but life-threatening condition.11,44 Although this evolution may parallel the change from using heparin to lock peripheral intravenous catheters to using saline flushes, is robust evidence available to support a similar change in practice for hemodynamic catheters? This clinical review summarizes the current...

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