Locking solutions for hemodialysis catheters; heparin and citrate--a position paper by ASDIN.
Research article published in Seminars in dialysis (2008)
Abstract
There is wide variation in the use of solutions to "lock" or fill tunneled central venous catheters for dialysis. Some centers use undiluted heparin concentrations ranging from 1000 to 10,000 U/ml and other centers place from 1000 to 10,000 U per lumen. Based on available evidence, it appears that heparin 1000 U/ml, or 4% sodium citrate are suitable choices for lock solution to maintain patency of tunneled central venous catheters for dialysis. Risks from systemic anticoagulation are lower with heparin 1000 U/ml and 4% sodium citrate, compared with higher concentrations of heparin (5000 and 10,000 U/ml). The need for use of tissue plasminogen activator for maintaining catheter patency is increased by using heparin lock at 1000 U/ml, vs. higher concentrations. Higher concentrations of heparin lock should be reserved for patients who have evidence of catheter occlusion or thrombosis when heparin is used at 1000 U/ml. Similar choices for lock solution are sensible for acute hemodialysis catheters. When heparin is used for catheter lock, the injected volume should not exceed the internal volume of the catheter.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
There is wide variation in the use of solutions to "lock" or fill tunneled central venous catheters for dialysis. Some centers use undiluted heparin concentrations ranging from 1000 to 10,000 U/ml and other centers place from 1000 to 10,000 U per lumen.
Por qué esto importa para la hirudoterapia
Este artículo evalúa soluciones de bloqueo — heparina (1000–10 000 U/mL) y citrato de sodio al 4 % — para mantener la permeabilidad de catéteres venosos centrales tunelizados para hemodiálisis, recomendando heparina o citrato a menor concentración para minimizar los riesgos de anticoagulación sistémica en comparación con concentraciones más altas de heparina. El resumen también señala que la necesidad de activador tisular del plasminógeno aumenta cuando se utiliza heparina a 1000 U/mL frente a concentraciones más altas. Para ASH, no existe relevancia directa: el resumen no menciona sanguijuelas, hirudina, hirudoterapia ni ningún compuesto derivado de la sanguijuela. ADVERTENCIA: no existe ninguna conexión defendible con la sanguijuela o la hirudina en este resumen; el tema se refiere al manejo de catéteres de diálisis con anticoagulantes convencionales no relacionados con la biología de la sanguijuela.
Citación
Locking solutions for hemodialysis catheters; heparin and citrate--a position paper by ASDIN.
Moran et al. · Seminars in dialysis, 2008
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: June 18, 2026