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maureen lawler
Continuous Vein to Vein Hemodialysis( CVVH)

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

Tom Billings
Maureen, The Clave and other
lynncrni
There are many concerns

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, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

aholtd
I am a nurse who manages an

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]

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