Blood Coagulation Disorders Clinical Trial
Official title:
A Prospective Study of Airless Tubing in an Inpatient Acute Hemodialysis Unit in Hospitalized Patients in a Large Medical Center
The introduction of unfractionated heparin (UFH), which prevents clotting of the
extracorporal circuit, was one of the key advances that led to the rapid development and
expansion of hemodialysis services. However, anticoagulation during hemodialysis of the
patient at high risk for bleeding remains a frequently encountered problem in both inpatient
and outpatient dialysis practice.
Streamline bloodlines are designed to eliminate blood-air contact. This is thought to help
reduce heparin use and decrease clotting rates. The goal of this study was to prospectively
examine impact of the Streamline airless blood tubing set, in an inpatient setting, on
dialysis circuit clotting rates, anticoagulation use, and dialysis efficiency.
The introduction of unfractionated heparin (UFH), which prevents clotting of the
extracorporeal circuit, was one of the key advances that led to the rapid development and
expansion of hemodialysis use, and remains the mainstay in hemodialysis practice today.
However, anticoagulation during hemodialysis of the patient at high risk for bleeding remains
a frequently encountered problem in the nephrology practice. The need for anticoagulation to
prevent clotting of the extracorporeal blood circuit and the need to prevent anticoagulation
related bleeding complications in the patient has led to the development of numerous
strategies; the safest from a bleeding standpoint being anticoagulant-free hemodialysis.
Streamline® bloodlines (Medisystems® Corporation, Lawrence, MA) are designed to eliminate
blood-air contact. A pressure pod measures arterial and venous pressures without any
blood-air contact. The venous chamber is run without an air gap. It is also designed so that
blood flows in a circular vortex manner. This airless system is thought to provide several
benefits: improved dialysis efficiency and blood flow rates, reduced heparin use and clotting
rates.
The goal of this study was to prospectively examine the Streamline® airless tubing system in
an inpatient setting and its association with clotting rates, and dialysis efficiency.
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