Effect of Heparin on Coagulation Tests: A Comparison of Continuous and Bolus Infusion in Haemodialysis Patients
Introduction: Haemodialysis is one of the most conventional treatments of chronic renal failure. The risk of clot formation is high during haemodialysis due to regular contact of blood with the surfaces of foreign objects such as catheters, dialyzers’ membrane, and other materials used for dialy...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2016-02-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/7231/18476_CE(Ra1)_F(AK)_PF1(PAY)_PFA(AK)_PF2(PAG).pdf |
| Summary: | Introduction: Haemodialysis is one of the most conventional
treatments of chronic renal failure. The risk of clot formation is
high during haemodialysis due to regular contact of blood with
the surfaces of foreign objects such as catheters, dialyzers’
membrane, and other materials used for dialysis. Therefore, to
prevent clot formation during haemodialysis, the dialysis system
requires anticoagulation; this is usually done by heparin.
Aim: The present study aimed to compare two heparinization
methods and determine the proper impacts of these methods.
Materials and Methods: In this quasi-experimental study,
80 haemodialysis patients covered by the dialysis center
of Amir-al-momenin Hospital of Zabol were studied in two
40-member groups of heparin therapy methods of bolus
injection and continuous infusion. PT and PTT were measured
in blood samples collected from all patients before starting
haemodialysis. The first group received 3000 units of heparin
once the haemodialysis machine started to work and 2000 units
of heparin two hours later as bolus injection. In the second
group, 1500 units of heparin was injected at the start of dialysis
after then, 5000 units of heparin (one mL) were mixed with 11
mL of distilled water and infused using a heparin injection pump
up to half an hour before the end of dialysis. At 30 minutes after
starting dialysis and at the end of 4 hours of haemodialysis,
PT and PTT were measured and compared between the two
groups.
Results: According to the results, the mean partial thromboplastin
time in the bolus and continuous heparin-receiving group
was 41.75±6.29 and 37.90±4.77, respectively, which was
statistically significant (p=0.036). But PT was 14.45±1.82 in the
bolus heparin group and 13.95±1.39 in the continuous heparin
group, which was not significant according to the results of
independent t-test (p=0.336).
Conclusion: The results indicated a statistically significant
difference between the bolus heparin injection and the
continuous heparin infusion groups in terms of coagulation
tests in haemodialysis patients (p=0.036). Therefore, given the
effects of heparin on coagulation, it was more effective in the
bolus heparin group than the continuous infusion group. It is
recommended to use the bolus method for heparin therapy
during haemodialysis. |
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| ISSN: | 2249-782X 0973-709X |