ASHP therapeutic position statement on the institutional use of 0.9% sodium chloride injection to maintain patency of peripheral indwelling intermittent infusion devices.

0.9% Sodium chloride injection is a safe and effective indwelling solution for maintaining catheter patency of peripheral indwelling intermittent infusion devices (PIIIDs) in adults and children age one year or older. ASHP supports the use of 0.9% sodium chloride injection in preference to heparin-containing flush solutions (heparin flush) in the institutional setting, on the basis of clinical evidence indicating that 0.9% sodium chloride injection (1) is as effective as heparin flush in maintaining the patency of PIIIDs when blood is not aspirated into the device, (2) is safer to use than heparin flush because of a lower potential for adverse effects, (3) avoids drug incompatibilities associated with heparin flush, and (4) is a cost-effective alternative to heparin flush. Because of limited and conflicting available scientific evidence to date, this recommendation is not applicable to children under the age of one year or patients in the home or other outpatient settings. This document is not applicable to catheters used for central venous or arterial access (including peripherally inserted central catheters and midline catheters) and the maintenance of patency in indwelling venipuncture devices used to obtain blood samples. Further research on PIIID patency in the aforementioned patient populations and settings is warranted.