Bibliographic information

GuidelineGuidelines for the prevention of bloodstream infections and other infections associated with the use of intravascular catheters: part 2: central venous catheters
Year of Publication2026
Issuing InstitutionWorld Health Organization

Recommendation

New

WHO suggests a system of “lockoff” flushing with normal sterile saline over “lock-off” flushing with heparinized saline for central venous catheters (CVCs) in adults, adolescents, children and neonates. (Short- and long-term catheters) (All population)

Recommended in favor

Conditional

Notes and Remarks

  • The GDG expressed concerns regarding the potential risk of heparin-induced thrombocytopenia, bleeding and allergic reactions with the use of heparinised saline for “lockoff” flushing.
  • However, the GDG also acknowledged that heparinized saline may have a favourable effect in decreasing the risk of deep vein thrombosis.
  • Use of multi-use vials of sterile saline and heparinized saline should be avoided due to the risk of potential contamination.