Linda Chan, MSN, RN, ONC, CMSRN, EBP-C, emphasized that patients should check with providers regarding the removal of larger heparin lines for flushes.
The removal of heparin may reduce potential toxicities and simplify saline-based flushing for patients undergoing treatment for cancers, according to Linda Chan, MSN, RN, ONC, CMSRN, EBP-C. In an interview with CancerNetwork® at the
She began by highlighting a potential reduction in toxicities associated with heparin, including hypersensitivity reactions and drug-induced thrombocytopenia, even at smaller heparin doses. Moreover, she highlighted that the process of flushing is easier for multidisciplinary oncology teams, which was also foregrounded by the findings she presented, which showed a reduction in financial toxicity for patients.
Finally, Chan touched upon a consideration for patients undergoing saline-based flushes, emphasizing that patients should check with providers regarding the removal of larger heparin lines. Specifically, she identified a threshold for consultation regarding heparin dosing to be 100 units/mL, with the study excluding patients with lines requiring 1000 units/mL of heparin.
As far as safety goes, any time that you are not exposed to a drug such as heparin, there's less of a chance that you'll react to it. Most [patients] can tolerate saline flushes [quite] easily, without any adverse reactions. But [patients] do react to heparin. They could have hypersensitivity reactions [or heparin-induced] thrombocytopenia, even at those small heparin flush doses.
The EBP changes would help the multidisciplinary team in that they make the process easier. I want to say that…the patient needs to make sure that their line is one of the lines that uses heparin at 100 units/mL vs one of the bigger lines that uses a higher strength heparin. [We] would need to check both the provider and the patient.
Chan L Castillo R, Johns M, Riley C, Youssefi F, Mendoza C. Preliminary outcomes of an evidence-based practice change using normal saline to flush peripherally inserted central catheters, ports, and central lines to maintain line patency in hospitalized oncology patients. Presented at: 51st Annual Oncology Nursing Society (ONS) Congress; May 13-17, 2026; San Antonio, TX. Poster 86
