Complications with heparin-lock needles. A prospective evaluation.

Because the frequency of complications related to heparin-lock needle usage is unknown, 221 heparin-lock needle insertions in 78 patients were observed for the development of complications. Upon removal of 119 heparin-lock needles from 42 patients, specimens were obtained for culture. Phlebitis was associated with 27 (12%) heparin-lock needle insertions. Only a positive flush culture of the heparin-lock needle system correlated with the development of phlebitis. Phlebitis developed during the first 4 days after heparin-lock needle insertion in two instances and later than 4 days after insertion in 25 instances. All positive flush cultures were obtained from heparin-lock needles in use for longer than 4 days. No patient developed clinically apparent systemic infection. These data suggest that heparin-lock needles should not be used for more than 4 days because, after 4 days of use, there is a significant risk of developing phlebitis, a lesser risk of developing contamination of the infusate in the heparin-lock needle system, and a potential risk of developing nosocomial infection.