Whole-blood activated coagulation time for evaluation of heparin activity during hemodialysis: a comparison of administration by single-dose and by infusion.
Whole-blood activated coagulation time (WBACT), measured by an automated technique, was used to estimate heparin activity in 12 patients in a chronic hemodialysis program. Identical heparin doses, calculated on a body-weight basis, were given to each patient, either as a single dose before a 3.5-4 hour dialysis, or as a loading dose followed by infusion during the first 1.5-2 hours of dialysis. Each dose regimen was repeated during four consecutive dialyses. The variation in heparin activity between the four dialyses did not exceed the standard deviation of the WBACT method. This indicates that the heparin requirement between dialyses was steady. Appreciable interindividual differences in heparin activity were found, however, showing that heparin requirement cannot be determined solely on a body-weight basis. Fibrin deposits in the venous drip chamber were uncommon during the first two hours but became more frequent towards the end of dialysis, the increase being significantly more with the single-dose than with the infusion regimen. Maintenance of heparin activity at the end of dialysis was better with the infusion regimen. Prolonged heparin infusion is preferable to single-dose injection to maintain the heparin effect and prevent fibrin deposits.
D000328:Adult; D000368:Aged; D000818:Animals; D005260:Female; D005337:Fibrin / Q000037:antagonists & inhibitors*; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D007263:Infusions, Parenteral; D007275:Injections, Intravenous; D007674:Kidney Diseases / Q000097:blood / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D013552:Swine; D013927:Thrombosis / Q000517:prevention & control*; D014914:Whole Blood Coagulation Time
D005337:Fibrin; D006493:Heparin