Anticoagulant free hemodialysis
Journal Title: Journal of the Indian Medical Association - Year 2018, Vol 116, Issue 12
Abstract
Anticoagulant is necessary to prevent blood clotting in the dialysate. Unfractionated heparin is the anti coagulant of choice. However, in many clinical situations, anticoagulant is strongly contraindicated, like recent surgery, intracranial bleeding, GI bleeding, poly trauma etc. When blood flow kept low as in continuous renal replacement therapy or sustained low efficiency dialysis, possibility of clotting is high and some form of anticoagulation is necessary. Regional citrate is suitable in these situations. However, citrate anticoagulant is not freely in India. Normal saline flush 100 ml every 10 to 15 min. interval into the blood compartment prior to filter flushes dialyzer and venous chamber as well as commonly used. In some blood tunings there is a net filter in the venous chamber and clotting starts there. If no clotting detected the procedure repeated every 10 to 15 min interval. When the blood flow is low as in prolonged intermittent therapy, clotting still happens esp. when flushing is delayed. 5-10% filter clotting is reported with this technique
Authors and Affiliations
Dilip Kumar Pahari
Keywords
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