Low dose heparin lock (1000 U/mL) maintains tunnelled hemodialysis catheter patency when compared with high dose heparin (5000 U/mL): A randomised controlled trial.
Randomized controlled trial published in Hemodialysis international. International Symposium on Home Hemodialysis (2016)
Abstract
Introduction Heparin is commonly used after hemodialysis treatments as a locking solution to prevent catheter thrombosis. The comparative efficacy and safety of different heparin concentrations to maintain catheter patency has been previously reported in retrospective studies. We conducted a prospective, randomised, controlled study of 1000 U/mL heparin (low dose) versus 5000 U/mL heparin (high dose) locking solution to maintain patency of tunnelled catheters. Methods One hundred patients receiving chronic, unit-based hemodialysis with newly placed tunnelled hemodialysis catheters (less than 1 week) were randomly assigned to either a low dose (n = 48) or high dose heparin (n=52). The primary intention-to-treat analysis examined time to malfunction in both groups over a 90 day period. A secondary analysis compared baseline patient characteristics in relation to catheter malfunction. Findings Overall rate of catheter patency loss was 32% of catheters by 90 days. There was no significant difference in time to malfunction of catheters locked with low dose or high dose heparin (P = 0.5770). Time to catheter malfunction was not associated with diabetic, hypertensive or smoking status. There was no difference in mean delivered blood flow rate, venous and arterial pressure, and dialysis adequacy between low dose and high dose groups. No patient suffered a hemorrhagic complication requiring hospitalisation during the study period. Discussion Low dose heparin is adequate to maintain tunnelled hemodialysis catheter patency when compared with high dose heparin. The study also suggests that there is no relationship between catheter malfunction and diabetic, hypertensive or smoking status.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Резюме
Introduction Heparin is commonly used after hemodialysis treatments as a locking solution to prevent catheter thrombosis. The comparative efficacy and safety of different heparin concentrations to maintain catheter patency has been previously reported in retrospective studies.
Почему это важно для гирудотерапии
В данном рандомизированном контролируемом исследовании сравнивались низкая доза (1000 ЕД/мл) и высокая доза (5000 ЕД/мл) гепарина в качестве запирающих растворов для туннелированных катетеров для гемодиализа у 100 пациентов в течение 90 дней; значимых различий между группами по времени до дисфункции катетера, достигаемой скорости кровотока, адекватности диализа или геморрагическим осложнениям не выявлено. Авторы приходят к выводу, что низкая доза гепарина достаточна для поддержания проходимости катетера. Для области интересов ASH данное исследование относится к дозированию антикоагулянтного запирающего раствора для ухода за катетером, что входит в клиническую антикоагулянтную практику. Однако в исследовании отсутствуют какие-либо упоминания пиявок, гирудотерапии или секретома пиявок, а любая значимость для области ASH ограничивается общим контекстом применения гепарина без обоснованной связи с пиявками.
Цитирование
Low dose heparin lock (1000 U/mL) maintains tunnelled hemodialysis catheter patency when compared with high dose heparin (5000 U/mL): A randomised controlled trial.
Chu et al. · Hemodialysis international. International Symposium on Home Hemodialysis, 2016
Связанный клинический контекст
Узнайте, как это исследование связано с клинической практикой
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