The life-threatening hemodialysis catheter heparin lock caused bleeding in a child after peritoneal catheter removal.
Hemodialysis catheter patency is regularly maintained by high-concentration heparin filling, according to manufacturer's recommendation. Surprisingly, there are only few reports on serious bleeding complications in children on dialysis. A case of serious, life-threatening hemorrhage in a child after tunneled peritoneal catheter removal because of hemodialysis catheter heparin lock flushing is described. Discussion of the literature data is presented. Further investigations are needed to develop the guidelines for pediatric dialysis catheter care, including the optimal concentration for heparin lock as the possible heparin alternatives, but until that moment, previously suggested guidelines to prevent hemorrhagic complications in dialyzed children should be emphasized.
Novak
Milivoj
M
Department of Pediatrics, University Hospital Center Zagreb, 10000 Zagreb, Croatia. mnovak@kbc-zagreb.hr
Cvitkovic
Miran
M
Galic
Slobodan
S
Luetic
Tomislav
T
Cavar
Stanko
S
Puretic
Zvonimir
Z
D058186:Acute Kidney Injury / Q000175:diagnosis / Q000628:therapy*; D001803:Blood Transfusion; D002404:Catheterization / Q000009:adverse effects*; D020878:Device Removal / Q000009:adverse effects*; D004868:Equipment Failure; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007223:Infant; D008297:Male; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000379:methods; D011479:Protamines / Q000627:therapeutic use; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
D011479:Protamines; D006493:Heparin