Heparin

[chessicle]

What do you all receive as anti-coagulation (blood-thinning) when you are on haemodialysis?  We are in the process of changing from standard, unfractionated heparin infusions to low molecular weight heparin, which is given as a push into the machine at the start of dialysis.  It is easier for the nurses, doesn't need monitored (therefore fewer blood samples are taken during a given dialysis session) and is thought to have some extra benefit over unfractionated heparin in terms of cholesterol.  Some of our patients have declined to change and some have asked to change back after a few sessions.  I haven't had the chance to ask any of them why myself, but the nurses tell me that it was all kinda woolly, just didn't like it, kind of reasoning.

What are your experiences?

[jbeany]

Oh heck - one more thing to ask that I didn't even know I needed to know. 

I'm on 500ml push per hour of hep.  I have no idea what kind.  They dropped it from 1000 because I bleed forever while I'm holding after each session.  Bu they are going to have to bump it back up because they keep getting clots in the lines.  I'm just going to have to get used to sitting for a half hour to 45 minutes after every session to wait to stop bleeding.

[brenda]

I use Heparin Leo, 1,000i.u./ml. 0.8 bolus and 0.8 each hour, off 60 minutes before end (3.5 hr run). I hardly bleed at all and I have no problems with clotting.

[Amanda From OZ]

I am on orgeron, i think i am the only person i know on it!!

[Epoman]

I use Heparin 5,000 units pushed at the beginning of treatment. I have even forgot to "push" it a couple of times and I did not have any problems.

- Epoman

[del]

Hubby uses heparin that you have to mix with saline overnight.( !0 000 iu/ml)  It pushes 0.7 /hr and automatically shuts off one hour before he is finished.  He uses 2000 in his venous needle when he starts(1000iu/ml) No problems with clotting or bleeding.  Is done bleeding usually in less than 5 minutes.

[AlasdairUK]

I use 1000 iu/ml. I have 1 ml bolus and 1 ml an hour for the first three with a one hour stop time for the last. I do not have a problem with clotting or stopping my exit site bleed. I was not aware of the different types of heparin.

[jedimaster]

jbeany...have you tried blooters to reduce the amount of Wait after dialysis?

And I am on .9 per hour of heparin...started at .7

[susie q]

I am on orgeron, i think i am the only person i know on it!!

I get this also.. my hair was falling out when I was on heparin.
It is also called Danaparoid.  My Neph told me the company that manufactures it is going to stop.

[Amanda From OZ]

really?? they are going to stop it?  i am allergic to anything else. What will you use?? 

Susie how long were you on it when u realized your hair was falling out? this is a very common side effect with blood thinners. Orgeron is the only one i know of without that side effect.

[susie q]

I only had heparin for a couple of months before the hair loss.  Stopped almost immediately when I was switched to the danaparoid.
I don't know when the company will stop making it.. Neph says we will worry about that when it happens.  All I know for sure is I will not be taking coumadin...  There is no sense in taking a drug everyday when you only need it 3 times a week.. but it doesn't work that way. 
Some people don't use anything and opt for saline flushes or when the machine indicates clotting.. to re-transfuse if possible and start over with new set-up.
Not gonna worry about it.. 

[Amanda From OZ]

Thanks susie!! i will talk to my neph also

[BigSky]

Mine is 5,000 unit bolus and 1,500 units a hour.

Believe its American Pharmaceutical Partners brand.

[boxman55]

I am allergic to heparin they give me some kind of citrate (not 100% sure of the pronunciation) also they make me take cumidin because I was clotting all the time and leaving blood in the machine. It is running ok now though. Boxman55

[Rerun]

Mine is only 500 units bolus and 500 for each hour stopping 1 hour before the end of dialysis.

[jbeany]

jbeany...have you tried blooters to reduce the amount of Wait after dialysis?

And I am on .9 per hour of heparin...started at .7

I've tried sure seals, but they don't put those on until after you stop bleeding in the first place.  What do you mean by blooters (blotters?)  All my center uses is gauze and pressure and lots of time.  They haven't offered anything else.  If they had anything to offer, I'm sure they would - I'm always the last one out the door, and they really hate waiting for me, especially on Saturday nights.

[jedimaster]

OOOOps...yes it is BLOTTERS. They don't offer them at the hospital but I buy them at the local pharmacy (USA)...they cost something like $3.50 a pack, which lasts 20 use days. They decrease the bleeding time by lots. It works for me. I used to "hold" and wait between 10 to 15 minutes per hole...now I only wait 4 minutes per hole. So, I hold with the blotter for 4 minutes and then apply the gauze and tape.

[jbeany]

Got a brand name on those? 

[jedimaster]

Visit this site:  www.seal-on.com   I use the Seal On blotters which are film strips that I cut in half. I cut that half into two and I use those two small pieces...one for each hole. It works for me and I can afford it (my wife claims that I am cheam and I should only use 1/2 in each hole)...I hope this helps

[Kitty Cat]

My husband uses cumadin because if he gets any amout of heparin, he will stop breathing. I've never heard of anybody allergic to it like that, but unfortunately it's happened twice. We have them put up signs and get a bracelet on him while he's in the hospital so everybody who works on him knows.

[jbeany]

thanks, jedi - I'll check the local pharmacy, and if they don't have them, I can always order online!