For newborn infants, recommended IVF fluids include:

Critically ill newborns frequently have umbilical lines through which medications are administered and blood samples frequently drawn.  Every line interruption requires flush.

For the larger newborn (> 1250 g), the line should be flushed with pre-prepared sterile single unit doses of NS. 

However, frequent flushes with normal saline provide an excess sodium (and chloride) load to tiny premature infants in the days before their diuresis and natriuresis.  Also, multiple entries into the bag of IVF running continuously to maintain the transducer port are discouraged as it poses an infectious hazard.  Therefore, when IVF are ordered for the < 1250 g newborn, a separate vial of IVF for “flush” should also be ordered.  This vial may be entered multiple times and should be discarded and replaced after 24 hours. 

Flush fluids are ordered without heparin.

These IVF are readily available as pre-made choices on the WizOrder NICU Fluid Ordering screen under NICU Maintenance IV Fluids and Umbilical Line Fluids. 

Resolved at Clinical Division Meeting 5/19/03