Anyone using sodium citrate 4% for locking central venous catheters when patient is allergic to heparin? Are you removing the sodium citrate prior to using catheter? Do you have success with maintaining patency?
Thanks for your reply,
Beth Ferguson CRNI
Hemodialysis catheters in our area are primarily locked with 4% sodium citrate dihydrate & have been successfully for ~2 years now. The solution is aspirated (5-7 mL) from the catheter prior to use of the line. I'm not aware of situations where this has yet been used in other CVADs; however, this should be a viable alternate when heparin is contraindicated, as you indicated. The volume of sodium citrate instilled equals the luminal/connector fill volume, as per local policy.
Daphne Broadhurst
Desjardins Pharmacy
Ottawa, Canada
Daphne Broadhurst
Desjardins Pharmacy
Ottawa, Canada
There are good studies about sodium citrate and catheter patency, but it is not available as a commercial product for catheter flushing in the US yet. A list of these references can be found in the 3rd in the series of webinars I did for INS last year now on their website.
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