Journal Article

Estimation of heparin leak into the systemic circulation after central venous catheter heparin lock

Mohsen Agharazii, Isabelle Plamondon, Marcel Lebel, Pierre Douville and Simon Desmeules

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 20, issue 6, pages 1238-1240
Published in print June 2005 | ISSN: 0931-0509
Published online June 2005 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfh841
Estimation of heparin leak into the systemic circulation after central venous catheter heparin lock

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Background. Although most catheter problems in haemodialysis are related to infection or clotting, bleeding associated with the heparin lock is of clinical importance especially during peri-operative conditions. The objective of this in vitro study is to estimate the volume of heparin that may leak into the circulation immediately after performing a catheter lock.

Methods. Different volumes (ml) of a dextrose solution were used to perform a catheter lock on haemodialysis catheters. The tip of the catheter was placed in a test tube containing water for a pre-specified period. The final concentrations of dextrose in the test tube were used to determine the volume of solution that leaked from the catheter.

Results. When the total lumen volume was filled, the catheter leak was estimated to be 0.59±0.03 and 0.71±0.04 ml after 15 and 25 s, respectively. There was a continuous leak of 1.23±0.41, 2.20±0.34 and 3.38±0.23 ml at 5, 15 and 30 min, respectively, after performing a catheter lock on a catheter with a total lumen volume of 4.5 ml. The catheter leak was significantly reduced when only 3.7 ml of solution was used to fill the total lumen volume of 4.5 ml.

Conclusion. The present study demonstrates a significant early and late leakage from the catheter that occurs after performing a catheter lock. When applied to heparin, the volume of the unwanted catheter leak may result in adverse clinical events, especially following haemodialysis sessions and during peri-operative periods. However, these results are hypothesis-generating, and clinical studies are necessary to evaluate the efficacy of underfilling.

Keywords: blood coagulation; catheter lock; dialysis catheters; haemodialysis catheter complications; heparin; heparin leak

Journal Article.  1655 words.  Illustrated.

Subjects: Nephrology

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