Sodium citrate 4% versus heparin as a lock solution in hemodialysis patients with central venous catheters

Yon, Calantha K.; Low, Chai L.

doi:10.2146/ajhp120300

Cited by 18 publications

(26 citation statements)

References 9 publications

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“…This incongruity might be attributed to the fact that: (1) we focused on a narrower spectrum of catheter removal, and (2) our study is likely to be better powered by including several recent large-scale RCTs. 3,13,15 In accordance with the literature, 20,25 thrombolytic treatments and thrombosis episodes were similar between citrate and heparin locks.…”

Section: Discussionsupporting

confidence: 85%

Citrate Versus Heparin Lock for Hemodialysis Catheters: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Zhao

Zhang

et al. 2014

American Journal of Kidney Diseases

102

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Section: Discussionsupporting

confidence: 85%

Citrate Versus Heparin Lock for Hemodialysis Catheters: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Zhao

Zhang

et al. 2014

American Journal of Kidney Diseases

102

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“…9 Also, sodium citrate 4% was as effective as heparin in the maintenance of catheter patency for long-term hemodialysis. 10 In addition, it was associated with fewer catheter-related Infections, bleeding risk and lower increase of the APTT when compared with heparin. 10 In our hospital, heparin was the most commonly used anticoagulant in the autotransfusion in patients undergoing orthopaedic spinal operations, but the surgeons always complained that autotransfusion was associated with a more significant derangement of the postoperative drainage output than homologous blood.…”

Section: Discussionmentioning

confidence: 98%

“…10 In addition, it was associated with fewer catheter-related Infections, bleeding risk and lower increase of the APTT when compared with heparin. 10 In our hospital, heparin was the most commonly used anticoagulant in the autotransfusion in patients undergoing orthopaedic spinal operations, but the surgeons always complained that autotransfusion was associated with a more significant derangement of the postoperative drainage output than homologous blood. Then we tried the sodium citrate 4% as an alternative to heparinised saline, and fortunately the drainage output declined after the alternation.…”

Section: Discussionmentioning

confidence: 98%

Coagulopathy associated with cell salvage transfusionfollowing cerebrovascular surgery

Zheng

et al. 2013

Pak J Med Sci

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A 35-year-old man was scheduled for dural arteriovenous fistula resection for vascular malformation under general anesthesia and a cell saver device was employed. The patient suffered from massive bleeding for the rupture of arteriovenous malformations from the beginning of the operation and 1000 mL cell-saved blood was transfused. After autologous blood transfusion and fluid resuscitation, blood oozed significantly from the surgical wounds, and the administration of cryoprecipitate and fibrinogen has no effect. The value of the activated coagulation time (ACT) increased to 999s. Considering the residual heparin in the autologous blood, ninety mg of protamine was intravenously injected, then 5 minutes later the ACT dropped to 147s. After the therapy, the surgical procedure was performed smoothly. The activated partial thromboplastin time (APTT) and the thrombin time (TT) of the postoperative venous blood was 18.9 s and 53.6 s respectively. Two days later, the APTT and the TT decreased to 12.1 s and 32.7 s without special treatment. The patient was discharged home without complications and well follow-up.

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“…Recently, Yon and Low performed study with 60 patients on HD receiving the heparin treatment and 58 patients receiving the sodium citrate as lock solution. There were significantly more CRB per 1000 catheter days in the heparin than the sodium citrate treatment group.…”

Section: Studies Using Prophylactic Antimicrobial Lock Therapy In Hd mentioning

confidence: 99%

Approach to prophylactic measures for central venous catheter‐related infections in hemodialysis: A critical review

Silva

Marchi

Mendes

et al. 2013

Hemodialysis International

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Vascular access is the major risk factor for bacteremia, hospitalization, and mortality among hemodialysis (HD) patients. The type of vascular access most associated with bloodstream infection is central venous catheter (CVC). The incidence of catheter-related bacteremia ranges between 0.6 and 6.5 episodes per 1000 catheter days and increases linearly with the duration of catheter use. Given the high prevalence of CVC use and its direct association with catheter-related bacteremia, which adversely impacts morbidity and mortality rates and costs among HD patients, several prevention measures aimed at reducing the rates of CVC-related infections have been proposed and implemented. As a result, a large number of clinical trials, systematic reviews, and meta-analyses have been conducted in order to assess the effectiveness, clinical applicability, and long-term adverse effects of such measures. In the following article, prophylactic measures against CVC-related infections in HD patients and their possible advantages and limitations will be discussed, and the more recent literature on clinical experience with prophylactic antimicrobial lock therapy in HD CVCs will be reviewed.

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Sodium citrate 4% versus heparin as a lock solution in hemodialysis patients with central venous catheters

Abstract: In patients with long-term hemodialysis catheters, a lock solution of sodium citrate 4% was associated with fewer CRIs and similar effectiveness when compared with heparin 5000 units/mL.

Cited by 18 publications

References 9 publications

Citrate Versus Heparin Lock for Hemodialysis Catheters: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Citrate Versus Heparin Lock for Hemodialysis Catheters: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Coagulopathy associated with cell salvage transfusionfollowing cerebrovascular surgery

Approach to prophylactic measures for central venous catheter‐related infections in hemodialysis: A critical review

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