Q What is the standard regarding isotonic sodium chloride solution versus heparin in pressure monitoring systems?

A Barbara Leeper, RN, MN, CCRN, replies:

Traditionally, heparin has been added to isotonic sodium chloride solution or 5% dextrose in water for use in maintaining patency of pressure monitoring catheters including arterial, pulmonary artery, and central venous pressure catheters. The use of heparin for intermittent flushes to maintain patency of peripheral catheters was discontinued by most clinicians several years ago. However, the practice has continued for maintaining patency of pressure monitoring catheters until recent years. Clinicians identified an opportunity to cut costs by using nonheparinized solutions for maintaining patency of these catheters; in addition, there is a real concern regarding the risk for the development of heparin-induced thrombocytopenia (HIT).

The evidence supporting the use of nonheparinized flush solutions is mixed. Most studies have been conducted on peripheral intravenous catheters and arterial pressure monitoring...

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