Systemic anticoagulation related to heparin locking of non-tunnelled venous dialysis catheters in intensive care patients
Research article published in Anaesthesia and intensive care (2016)
Abstract
Heparin locking of venous dialysis catheters is routinely performed in intensive care to maintain catheter patency when the catheters are not being used. Leakage of heparin into the circulation can potentially cause systemic anticoagulation and may present a risk to intensive care patients. To assess the effect of 5000 units per millilitre heparin locking of non-tunnelled dialysis catheters on systemic anticoagulation, we performed a prospective observational study of ten intensive care patients receiving heparin locking of dialysis catheters in an adult tertiary intensive care unit between July and September 2015. Activated partial thromboplastin time (APTT) was measured prior to, and three minutes after, heparin locking of catheter lumens with the manufacturer's recommended locking volume to assess the effect on systemic anticoagulation. Heparin locking of venous dialysis catheters resulted in a significant rise in APTT (P=0.002). The median rise was by 56 seconds (interquartile range 30-166.5). Following heparin locking, 80% of patients had APTT values within or above the range associated with therapeutic anticoagulation. Heparin locking of non-tunnelled venous dialysis catheters can cause systemic anticoagulation in intensive care patients and therefore poses a potential risk to patient safety.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.
Por qué esto importa para la hirudoterapia
Este pequeño estudio observacional prospectivo de diez pacientes de cuidados intensivos encontró que el sellado con heparin de catéteres de diálisis no tunelizados provocó un aumento significativo de la aPTT (P=0.002), con un 80% de los pacientes alcanzando valores de aPTT dentro o por encima del rango de anticoagulación terapéutica, lo que indica una fuga sistémica de heparin y un riesgo potencial de seguridad. Para la narrativa de la hirudoterapia, esto sirve como una ilustración más de los efectos sistémicos impredecibles de la heparin, reforzando por qué son de interés los enfoques anticoagulantes de acción local que no sean heparin. La advertencia es que se trata de un único estudio observacional pequeño (n=10) sobre el sellado de catéteres con heparin, no sobre sanguijuelas o hirudin, por lo que su relevancia es puramente como contexto de apoyo sobre las limitaciones de la heparin.
Citación
Systemic anticoagulation related to heparin locking of non-tunnelled venous dialysis catheters in intensive care patients.
Bong et al. · Anaesthesia and intensive care, 2016
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: June 18, 2026