[Comparative study between 20 IU/ml heparin and 5% heparin/urokinase 5000 IU lock in hemodialysis central venous...

The central venous catheter prevalence as a permanent hemodialysis vascular access is growing in the last years. However, there is no consensus in the scientific community about what is the most appropriate lock solution to avoid complications.

To compare the effectiveness and the cost between heparin 20 IU/ml (SH20) lock solution versus usual pattern (UP), consisted on 5% heparin/5000 IU urokinase lock solution in hemodialysis catheters with patency problems.

Experimental comparative study. Patients with a permanent hemodialysis central venous catheter with patency problems were included. Catheters were locked with SH20 during 6 sessions and with 5% heparin/5000 IU urokinase during another 6 sessions, depending on the patient.

Of 50 patients in our unit, 7 fulfill the inclusion criteria. 42.9% had arterial branch resistance and 57% both branches resistance. Blood flow and venous pressure was similar in both periods. Blood lines reversal percentage was 15.85% using SH20 and 20.61% for UP, not statistically significant in all cases. The lock cost was 1 Euro/session with SH20 and 2.78 Euro/session with UP.

20 IU/ml heparin as a lock solution for hemodialysis catheters is as effective as the usual patterns but involves less systemic risk to the patient, reduced workload for nurses and lower cost per session.