Case ReportsCase Report: The Heparin Flush Syndrome: A Cause of Iatrogenic Hemorrhage

The anticoagulant drug heparin is used extensively in modern hospital practice. The major therapeutic use of this drug remains treatment and prevention of systemic thrombosis. However, an increasing amount of heparin is being used in nontherapeutic protocols to implement newer, more invasive technology when the body’s protective clotting mechanism would otherwise interfere. Buried in protocols, heparin has become ubiquitous in standard hospital practice. One such protocol is the use of heparinized solutions to “flush” arterial and venous catheters in order to maintain patency and thus, vascular access. Often these flush solutions are considered to be as innocuous as “simple saline.” We report a patient who experienced postoperative bleeding resulting from overuse of “heparin flushes,” and necessitating a second surgery. The excessive hemorrhage following this inadvertent anticoagulation has been named the “heparin flush syndrome,” to call attention to the serious and sometimes fatal side-effects of heparinized solutions.