Can Flush and Lock Solutions Used in Human Medicine Be Applied to Large Animal IV Therapy: A Systematic Review

A recent shortage of prepackaged heparinized saline (HS) syringes has led to the question of whether or not normal saline (NS) can be used to both flush and lock IV catheters in large animal medicine (LAM). Moreover, several known medication incompatibilities exist with IV heparin administration. This is of particular concern in veterinary medicine where limited to no compatibility data exists between “veterinary only” (non-Food and Drug Administration approved) medications and heparin. Most of the literature on this subject is in human medicine where flushing of peripheral IV lines (PIVL) is done safely and effectively with NS. The jugular lines inserted in LAM have characteristics that are more similar to PIVLs versus most central venous access devices used in human patients. In addition, LAM catheters are of larger diameter than those typically used in human medicine thereby reducing the risk of occlusion. Based on the data evaluated, flushing and locking all LAM catheters with of NS is a reasonable alternative method for maintaining IV patency and eliminating problems associated with medication-related incompatibilities or shortages of prepackaged HS syringes.