Heparin stability in parenteral nutrition bags prepared in a neonatal ICU

Introduction

Heparin is commonly given in our neonatal ICU (NICU) by continuous intravenous infusion. Heparin is diluted in parenteral nutrition bags and administered over a period of 24 hours with in-line filtration. However, there are no data on heparin stability in parenteral nutrition bags, especially on its compatibility with 50% dextrose mainly present in bags. The aim of our in vitro study was to determine heparin stability in parenteral nutrition bags prepared in a NICU after 24-hour infusion and to assess its interaction or not with 50% dextrose.

Methods

We prepared both types of bag: parenteral nutrition bags whose composition was defined in the unit, including sodium heparin (77 UI/ml); and bags containing only sodium heparin diluted in 50% dextrose (193 UI/ml). These bags (n = 6 per type) were infused over a period of 24 hours with and without in-line filtration. Heparin activity was measured using a chromogenic anti-Xa method in bags just being prepared (references for other measures) and after 24-hour infusion and in effluents at the end of infusion line after 24 hours.

Results

Our results show values of heparin activity measured in bags and effluents with and without in-line filtration after 24-hour infusion for both types of bag assessed (Tables 1 and 2). Results are expressed as median values (minimum to maximum) in percent.

Table 1 Results of heparin activity in parenteral nutrition bags

Table 2 Results of heparin activity in bags with sodium heparin in 50% dextrose

Conclusion

We conclude that there is no loss of heparin activity when drug is infused over 24 hours for both types of bag prepared, with and without in-line filtration, showing heparin activity remains stable during this period and there is no interaction of drug with other nutrient components of bags, especially 50% dextrose.