I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: tyefly on February 15, 2010, 11:20:02 AM
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I would sure like to know how much heparin everyone is using ..... incenter or homehemo people..... I have done some research on here and found so many side effect which were alarming..... Since I started D no one has told me anything about Heparin.... this drug is serious and I believe we need to know how it is use... so can you just list how much and how long your treatment time is..... and do you to do they give it to you just when you start up...... thx
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All I can say is what we have found works for us, using the NxStage system it took a very long time to finally settle on an amount that effectively reduced the "clot" that always seemed to be in the "pod" at the end and rinse back. What I do is give her 4ooo units through the venous line at the beginning and half way through the days run give her another 3000 units through the port on top of the filter (3-1/2 hour run average). If you try this, putting it in the filter port, do it VERY slowly or it will alarm as it thinks it is seeing air in the line.......
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Jenn does 5000 units at the start I believe. She plays around with it based on her blood flow rate if she saw clots the day before, etc. 5000 units seems to work most of the time at her blood flow rate of 380 ml/min for 2.5 hours. When she was pregnant and on for 4 hours we would start with 7500 and sometimes add an extra 500 every 30 minutes if it started to clot. I think nocturnal types get a heparin pump for their machine. Our nurse said if you ran below 300 ml/min you had to have one. Although I have heard of people running without heparin without problems. That has never been the case with our machine.
In mid-2008, She clotted a bunch of NxStage filters in a row with white blood cells and fibrin after 2 hours. We were worried that Jenn had some condition called "white clot" where the body is allergic to heparin but it turned out to be a manufacturing problem with the filters from NxStage. We had to pack a few clotted used cartridges with ice packs and ship them to NxStage's lab. We never got an official verdict, but the problem stopped with a new lot of cartridges. (Their cartridge quality is a lot better now days! We used to have leaky balance chambers at least once a week.)
The biggest problem people make with heparin is using the 5000 unit/mL heparin like it is 1000 unit/mL heparin. The 5000 unit/mL heparin is for hep-locks on catheters. If you use it like the 1000 unit/mL heparin you get 5 times the dosage.
We survived the contaminated Baxter heparin panic of 2008 too. Fun times. Lots of heparin in the trash.
Heparin is just a blood thinner to help keep you from clotting the machine. All the warnings for heparin are usually the same as any other blood thinner like warfarin. Dialysis is very effective in removing heparin. That's why the machines clot up eventually.
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I run 4 hours. They give me 3000 units in the beginning and 1000 the next 2 hours and hold the last hour.
Dialysis itself is a bad side affect. Heparin saves you form clotting. They could "flush" you with saline every 15 minutes but that fills you with fluid. I don't know what your choice is except to find out the minimum you need before you clot and use that.