| Recombinant tissue plasminogen activator is a useful alternative to heparin in priming quinton permcath. | |
| | |
MedLine Citation:
|
PMID: 10620554 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Soft, cuffed, implantable central venous catheters such as the Quinton Permcath (Quinton Instrument Co, Seattle, WA) are increasingly used as permanent access in patients with end-stage renal disease. Their major limitations, besides infection, are thrombosis and inadequate blood flow. To prevent those complications, heparin is conventionally used for priming the Quinton Permcath between dialysis sessions. In this study, we compared recombinant tissue plasminogen activator (rTPA) with heparin for priming the Quinton Permcath in a prospective, randomized, crossover design. Twelve patients were randomly assigned to receive 2,000 IU of heparin or 2 mg of rTPA injected into each catheter lumen at the end of each dialysis session over a period of 4 months, followed by a switch to the other substance. Blood flow rate (flow), venous pressure (VP), and arterial pressure (AP) were monitored at each dialysis session hourly. Flow was significantly greater (P = 0.0001) with rTPA (mean +/- SD, 237.7 +/- 18.1 and 231.6 +/- 12.4 mL/min for the first and second 2 months, respectively) compared with heparin (208.5 +/- 10.1 and 206.9 +/- 14.2 mL/min for the first and second 2 months, respectively). VP was significantly less (P = 0.0001) with rTPA (135.4 +/- 8.2 and 140 +/- 15.2 mm Hg for the first and second 2 months, respectively) compared with heparin (160.5 +/- 16.1 and 159.2 +/- 20.7 mm Hg for the first and second 2 months, respectively). AP was significantly greater (P = 0.0002) with rTPA (-113.5 +/- 11.8 and -115.9 +/- 12.7 mm Hg for the first and second 2 months, respectively) compared with heparin (-136.5 +/- 23.3 and -134.7 +/- 25.8 mm Hg for the first and second 2 months, respectively). In addition, fewer complications (flow problems, clotting, and need for fibrinolysis) occurred in the rTPA period. These results show that rTPA is superior to heparin for priming the Quinton Permcath between hemodialysis sessions and can be used as a valuable alternative to conventional heparin in selected patients. |
| | |
Authors:
|
P Schenk; A R Rosenkranz; G Wölfl; W H Hörl; O Traindl |
Related Documents
:
|
8166524 - Safe use of heparin-coated bypass circuits incorporating a pump-oxygenator. 1440524 - Comparative studies in vitro and ex vivo on the anticoagulant effect of a reversible an... 7628064 - Pentoxifylline inhibits mediator synthesis in an equine in vitro whole blood model of e... 9074814 - Coating in vitro of erythrocytes with tamm horsfall-protein. 2399874 - Chemiluminescence and chemotaxis assay of canine granulocytes: a methodological study. 2372794 - Changes in the microcirculation in slow and fast skeletal muscles with long term limita... |
Publication Detail:
|
Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
|
Title: American journal of kidney diseases : the official journal of the National Kidney Foundation Volume: 35 ISSN: 1523-6838 ISO Abbreviation: Am. J. Kidney Dis. Publication Date: 2000 Jan |
Date Detail:
|
Created Date: 2000-01-12 Completed Date: 2000-01-12 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 8110075 Medline TA: Am J Kidney Dis Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 130-6 Citation Subset: IM |
Affiliation:
|
Department of Internal Medicine III, Division of Nephrology and Dialysis, University of Vienna, Vienna, Austria. peter.schenk@akh-wien.ac.at |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Arteriovenous Shunt, Surgical Blood Flow Velocity / drug effects Catheters, Indwelling* Cross-Over Studies Female Fibrinolysis / drug effects Graft Occlusion, Vascular / blood, prevention & control* Heparin / administration & dosage*, adverse effects Heparin, Low-Molecular-Weight / administration & dosage*, adverse effects Humans Kidney Failure, Chronic / therapy* Male Middle Aged Prospective Studies Renal Dialysis* Tissue Plasminogen Activator / administration & dosage*, adverse effects |
| Chemical | |
Reg. No./Substance:
|
0/Heparin, Low-Molecular-Weight; 9005-49-6/Heparin; EC 3.4.21.68/Tissue Plasminogen Activator |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Biological dynamics of viral load in hemodialysis patients with hepatitis C virus.
Next Document: Secondary (AA-type) amyloidosis in patients with polymyalgia rheumatica.