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Ramon Romero
Autonomous University of Barcelona
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46.7% vs heparin 5%). The amount of anticoagulant administered corresponded to the volume of the catheter lumen.
The protocol was applied in 10 patients with acute renal
failure on conventional haemodialysis with double-lumen catheter. In all cases, 2500 IU of dalteparin were used during
haemodialysis. Four catheters were inserted into the right
jugular vein and six in the internal femoral vein. Samples were
taken peripherally 60 min after the haemodialysis session.
Sixty minutes after filling of the catheter, coagulation
status remained unchanged (prothrombin time 85%; partial
thromboplastin time 37 min 6 s) in patients in whom sodium
citrate was used, thereby avoiding the risk of bleeding,
whereas it was altered in 100% cases when 5% heparin was
used (prothrombin time 64.7%, partial thromboplastin time
90 s) (Figures 12).
Mean blood flow of 287 ml/min was maintained after 2
weeks of follow-up in catheters filled with sodium citrate.
No patient presented alkalosis or hypocalcaemia resulting
from sodium citrate administration.
Despite the difficulty in establishing a single filling protocol
for haemodialysis catheters which avoids flow blockage and
the risk of bleeding, we recommend filling the catheter with
sodium citrate 46.7%.
Department of Nephrology
Hospital Universitari Germans
Trias i Pujol
Badalona
Spain
B. Bayes
J. Bonal
R. Romero
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