NDT Advance Access originally published online on September 26, 2007
Nephrology Dialysis Transplantation 2007 22(12):3533-3537; doi:10.1093/ndt/gfm452
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Exit of catheter lock solutions from double lumen acute haemodialysis catheters—an in vitro study*
1Department of Anesthesiology, University of Florida College of Medicine, Gainesville, FL, USA, 2Marmara University, Istanbul, Turkey, 3Department of Surgery and 4Department of Medicine, University of Florida College of Medicine, Gainesville, FL, USA
Correspondence to: Murat Sungur, MD, Department of Anesthesiology, PO Box 100254, Gainesville, FL 32610-0254, USA. Email: msungur{at}anest.ufl.edu
 |
Abstract |
|---|
Background. Double lumen dialysis catheters are routinely heparin or citrate ‘locked’ to maintain patency. Heparin lock-related bleeding episodes and antibiotic lock-related toxicity have been reported. The aim of this study is to quantify the amount of leak during ‘lock’ procedures and to compare leakage for different double lumen dialysis catheters.
Methods. In an experimental, in vitro study at a University research laboratory, five different double lumen dialysis catheters were tested using three different lock volumes.
Results. Using the catheter flush volume, leak ratios for Flexxicon II 15 cm and 20 cm catheters were greater than that seen in the Arrow 16 cm catheter (P < 0.05). Using 20% less than the catheter flush volume, the Flexxicon IITM 20 cm catheter had greater leak than the Duo-flow 15 and 20 cm catheters and Arrow 16 cm catheter (P < 0.05). The Flexxicon IITM 15 cm catheter had greater leak than the Duo-flow 15 cm and Duo-flow 20 cm catheters with 20% less locking volume (P < 0.05). Using 20% greater than the catheter flush volume, the Duo-flow 20 cm catheter had significantly less leak ratio than the Flexxicon IITM 20 cm catheter (P < 0.05). There were no other significant differences in leak ratios between the catheters.
Conclusion. All double lumen dialysis catheters we tested have a substantial amount of leak even when the catheter ‘lock’ volumes were used, and leak ratio increases significantly with 20% overfill. There is a leak even when using 20% less ‘lock’ volume. The amount of leak can be clinically important and may explain the reports of bleeding episodes after heparin lock and antibiotic toxicity after antibiotic and anticoagulant combination lock. Some devices have lower leak ratios than others, likely related to catheter design.
Keywords: complications; dialysis catheter; heparin; heparin leak
*A part of this study was presented in the 10th Annual Conference on Continuous Renal Replacement Therapies, Dan Diego, California, 10–12 March 2005.
Received for publication: 1. 2.07
Accepted in revised form: 12. 6.07
CiteULike 
Connotea 
Del.icio.us What's this?
Related articles in NDT:
- In this issue ...
NDT 2007 22: i.[Extract] [FREE Full Text]
This article has been cited by other articles:
|
|
 |
|
  I. Markota Reply Nephrol. Dial. Transplant., July 1, 2009; 24(7): 2295 - 2295. [Full Text] [PDF]
|
|
|
|
|
|
I. Markota, D. Markota, and M. Tomic Measuring of the heparin leakage into the circulation from central venous catheters--an in vivo study Nephrol. Dial. Transplant., May 1, 2009; 24(5): 1550 - 1553. [Abstract] [Full Text] [PDF]
|
|