Resumo

SANCHEZ VILLAR, Isidro et al. Do we need heparin in the dialyser priming solution?. Rev Soc Esp Enferm Nefrol [online]. 2011, vol.14, n.4, pp.215-221. ISSN 1139-1375.

Introduction: Haemodialysis (HD) lines are traditionally primed with sodium heparin and saline solution, which entails the haemorrhagic risk associated to the passing of heparin into the blood. Aim: To compare HD dialyser priming with and without sodium heparin, in terms of coagulation, dialytic efficacy, and economic efficacy. Material and Method: A randomized, prospective studio of 3482 sessions with 109 HD patients (X 66.8±15 years, 40% women, 44% diabetic, 45% with high-flow tunnelled catheter, 50% native IAF, 5% prosthetic IAF). 1827 sessions carried out with fifty-nine patients were included in the control group (primed with saline solution + sodium heparin) and 1455 sessions with patients in the study group (primed with saline solution). The monitoring period was 5 months. Variables related to the coagulation of the circuit and the efficacy of the dialysis were analysed: Selected blood flow (Qb) and effective Qb, final status of the dialyser, number of changes of dialyser, number of changes of the arterial line, number of changes of the venous, average Kt/hour measured by ionic dialysance and heparinization of the circuit. The efficacy in economic terms was also studied. Results: There are no significant differences in the results related to coagulation and efficacy of the dialysis obtained in both groups, except X of heparin with low molecular weight (2476±1089 IU in the study group compared to 2854±1414 IU in the control group). Priming without heparin represents a saving of 0.50 € per session. Conclusions: Priming with saline solution does not affect the HD dose, and does not entail a greater risk of coagulation of the system compared to a priming solution to which heparin has been added, avoids the risk of heparin passing into the bloodstream, reduces handling in the connection protocols and reduces costs.

Palavras-chave : Heamodialysis; Priming protocol; Priming without heparin; Coagulation.

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