Our ICU is taking on this task and is having many ?'s . They would like to connect right through the clave but in the past the Hemo RN's told them they had to be removed. Also one of the Hemodialysis MDs has suggested that the lines not be heparinized . Our IV Team has nothing to do with Dialysis but I do have concerns about how these catheters are cared for. Anybody out there have any experience with CVVH? Thanks
Maureen,
The Clave and other needle-less connectors do not flow at a rate high enough to support Dialysis. We have a specifically designed connector calle TEGO for dialysis. Please contact me at [email protected] and we can get you some trial product. You can review the product at http://www.icumed.com/tego-connector.asp.
Thanks,
Tom Billings, RN
There are many concerns about the use of heparin. I just posted an entry to my blog about this, so you might want to check there for more information. If you do not use heparin, then what are they recommending to be used to lock these catheters? Or are you talking about the use of heparin in the continuous fluid flow? The only alternatives to heparin locking now are alteplase and lepirudin. There are other solutions being used in other countries but they are not available in the US yet.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
I am a nurse who manages an IV team, in-patient dialysis unit, and renal transplant unit. My nursing experience is 28 years in dialysis, predominantly acute and spent 5 years on the IV team. From my experience with dialysis, using the Tego connector in the acute setting is not a good idea. There are frequent chances to introduce bacteria by bedside nurses and the catheters are locked with large doses of heparin. We do many CRRT/SLED treatments and have started locking the catheters with 4% trisodium citrate solution to prevent the nurses giving high doses of heparin. Our anticoagulation that we use during dialysis is citrate, heparin, and sometimes argatroban. There are also triple lumen dialysis catheters made by Kendall that have a seperate lumen (like a pigtail) that the nurses can give fluids through whereby the lumen is seperate form the larger dialysis lumens. Hope this helps.
Dana Aholt BSN, RN, CNN
University of MO Columbia
[email protected]