We currently use heparin 10 units per ml for all lines except ports (100 units/ml). Our director wants us to change to 100 units per ml for all patients who use the line for apheresis procedures. Does anyone know of any literature that would support this? Lynn, what is your take on this?
I can not answer your question directly but am now going through the all the literature I can find on this issue. The apheresis procedure requires a minimum flow rate of ~70 mL per sec. This is similar to a dialysis catheter but the needed flow rate is much greater around 300 mL per second. It seems like the thought is that a larger amount of heparin would improve the catheter patency and subsequently the needed flow rate. The same thought has been applied to dialysis catheters with some using 5000 units to lock those lines. I think there are other issues involved such as flushing technique, coagulopathies in the patient, catheter tip location, just to name a few. If I find anything I will let you know, but I doubt there is a published study specifically about this type of use. Lynn
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