Estudio piloto comparativo de dos soluciones de sellado en catéteres de hemodiálisis:heparina sódica al 5% frente a fibrilin®

Abstract

Catheter locks in haemodialysis are usually a source of controversy among the different professionals involved in haemodialysis.The aim of this study is to compare two haemodialysis catheter lock solutions: 5% heparin and fibrilin (heparin 20ui/ml + methyl and propyl paraben).
We studied 8 patients (women) aged 69±12 years with tunnelled catheters of 17±7 months’ dura-tion, whose condition was stable and who had gi-ven their consent to the study. Initially, the fi brilin lock solution was used with the catheters for one month (12 sessions) and then 5% heparin for the same length of time. Pump speed, effective fl ow, venous pressure, KT, the need to use fi brinolytics, infections, number of handlings, hypotension epi-sodes, recirculation, KT/V, TP, TPTA were mea-sured. The results were compared using student’s t-test.After two months of study, a greater effective fl ow 318±23 ml/m was observed in catheters with heparin lock compared to 307±17 ml/m with fi -brilin (p= 0.008), lower venous pressure 147±12 mm Hg in heparin compared to 168±17 in fi bri-lin (p=0,006), higher KT in heparin 43±3 litres compared to 41±4 litres in fi brilin. Despite these better conditions, they did not represent clini-cal differences in dialysis effi cacy, KT/V heparin 1.56±0.2 compared to 1.59 ±0.2 in fi brilin. A hig-her number of catheter handlings was observed in heparin 12±0.2 compared to 9.4±1.3 in fi brilin (p=0.001). There were no differences in the appearance of infections, recirculation, need for fi brinolytics or coagulation alterations.We conclude that the use of fi brilin lock solution for haemodialysis catheters is an effective alternative to 5% heparin. It is not accompanied by a higher degree of catheter dysfunction but does involve less handling, which could lead to fewer catheter-associated infections.