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Dose of heparin for maintenance of patency of central Vascular catheter and how to prepare¿
For cvl patency as heparin it depends on concentration rather than dose , range from 10 iu/ml upto 100 iu/ml in pediatric.
Only on neonate it can be used as infusion with rate at 0.5 to 1 iu/kg l/hr for line patency For preparation First determine lumin size for example 3 ml Second define desirable concentration for example 10 iu/ml Third define ampoule concentration which is almost 5000 iu/ml Fourth make serial dilutions to take desired 30 iu ( dilute 5000 iu inn50 ml NS it will make 100 iu/ml then take 0.3 ml dilute to 3 ml ns )and dilute upto 3 ml with normal saline and lock it in each port for minimum 8 hours
Neonates:
Maintaining patency of central vascular catheters:
0.5 units/kg/hour.
Maintaining patency of peripheral vascular catheters:
0.5 to 1 unit/mL of IV fluid.
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Pediatrics:
Maintenance of Patency of Peripheral Arterial Catheters (continuous):
1 to 5 units/mLÂ of IV fluid (normal saline) at a rate of 1 to 2 mL/hour.
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Central line flush, patency (intermittent doses):
In neonates, the 10 units/mL concentration is used with frequency and volume of flushing determined by the type of catheter; capped polyvinyl chloride catheters and peripheral heparin locks require flushing more frequently (eg, every 6 to 8 hours). Volume of heparin flush is usually similar to volume of catheter (or slightly greater) or may be standardized according to specific hospital policy (eg, 0.5 to 1 mL/flush). Additional flushes should be given when stagnant blood is observed in catheter, after catheter is used for drug or blood administration, and after blood withdrawal from catheter.
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Dose of heparin flush used should not approach therapeutic unit per kg dose.
You will find the doses well established on LexiDrugs and Micromedex
Check the comment on my answer
Monagle P, Chan AK, Goldenberg NA et al: Antithrombotic Therapy in Neonates and Children: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest Feb, 2012; 141(2 suppl): e737S-e801S.
Shah PS: Continuous heparin infusion to prevent thrombosis and catheter occlusion in neonates with peripherally placed percutaneous central venous catheters. Cochrane Database Syst Rev 2008; 2008(2): 1.
Monagle P, Chan AK, Goldenberg NA et al: Antithrombotic Therapy in Neonates and Children: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest Feb, 2012; 141(2 suppl): e737S-e801S.
de Neef M, Heijboer H, van Woensel JB et al: The efficacy of heparinization in prolonging patency of arterial and central venous catheters in children: a randomized double-blind trial. Pediatr Hematol Oncol Dec, 2002; 19(8): 553-560.
Randolph AG, Cook DJ, Gonzales CA et al: Benefit of heparin in peripheral venous and arterial catheters: systematic review and meta-analysis of randomised controlled trials. BMJ Mar28, 1998; 316(7136): 969-975.
Butt W, Shann F, McDonnell G et al: Effect of heparin concentration and infusion rate on the patency of arterial catheters. Crit Care Med Mar, 1987; 15(3): 230-232.
Sellden H, Nilsson K, Larsson LE et al: Radial arterial catheters in children and neonates: a prospective study. Crit Care Med Dec, 1987; 15(12): 1106-1109.