Heparin Safety in the Neonatal Intensive Care Unit: Are We Learning From Mistakes of Others?

Current publicity detailing life-threatening heparin errors in neonatal intensive care units have brought attention to the incidence of medication errors in neonatal population as well as contributing factors specifically associated with these errors. With much attention given to labeling of product, internal system deficiencies, and role responsibility of nurse(s) administering the heparin solution, little attention has been given to rationale regarding evidence, or lack thereof, for use of heparin, especially as a flush solution for locked vascular access devices. A brief discussion of use, risks, and precautions with heparin and a common low-molecular-weight heparin, enoxaparin, is presented. In addition, the article includes an analysis and summary of research findings comparing efficacy of heparinized solutions vs normal saline in the neonatal and infant population for maintenance of peripheral intermittent intravenous devices.

Keywords: Heparin safety, Low-molecular-weight heparin (LMWH), Heparin use in neonatal ICU, Heparin lock