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Int J Artif Organs. 2013 Oct;36(10):725-9. doi: 10.5301/ijao.5000253. Epub 2013 Oct 2.

Rinsing the extra corporeal circuit with a heparin and albumin solution reduces the need for systemic anticoagulant in hemodialysis.

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1
Department of Public Health and Clinical Medicine, Umeå University, Umeå - Sweden.

Abstract

BACKGROUND:

Systemic anticoagulation during hemodialysis (HD) increases the risk for bleeding complications pre- or post-operatively. Based on the concept of blood-membrane interaction, we developed a heparin-albumin solution to rinse the dialysis circuit before start. The aim of this study was to investigate if this method was a valuable tool for our patients at risk for bleeding complications.

MATERIAL AND METHODS:

This retrospective, comparative, quality assessment study included 248 HD in 68 patients; Group1: 178 treatments were performed at patients for risk of bleeding using heparin-albumin-priming and Group 2: 70 acute HD were performed on patients without increased risk of bleeding using a bolus of heparin at start and a continuous infusion of heparin. In Group 1 additional heparin was given upon suspicion of progressive clotting. One L saline contained albumin (1 g/l) and heparin (5000 U/l) used for priming. Excess priming solution was removed by filling the circuit with blood at start of treatment.

RESULTS:

In Group 1, a mean total dose of 2000 U of heparin was given during the HD (18% performed HD without any heparin) and Group 2 used a mean total dose of 5500 U (p<0.001). There was no increased incidence of clotting in Group 1 versus Group 2 compared to standard HD. No bleeding complications were reported during any of the HA-priming treatments.

CONCLUSIONS:

Heparin-albumin priming resulted in a reduced total dose of heparin. There was no increased clotting and no incidence of bleeding was reported in either group.

PMID:
24254840
DOI:
10.5301/ijao.5000253
[Indexed for MEDLINE]
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