INCREASED HEPARINIZATION AND ITS EFFECT ON DIALYZER REUSE

The purpose of this study was to evaluate the effect of increased hepa rinization on dialyzer reuse The patients' heparin therapy (prior to a nd during the study) ,as prescribed through the use of heparin kinetic s (Gotch and Keen) to ensure cautious heparin administration and to mi nimize the increased risk of bleeding to the patient. Twenty-four pati ents opt chronic hemodialysis completed the six-month study. Their dia lyzers were reused an average of approximately 10.5 times. The paramet ers measured prior to and during the study included whole blood partia l thromboplastin times (WBPTTs), heparin administration, and dialyzer volumes measured postdialysis by an automated reuse system. Each patie nt's heparin therapy was increased during the study to achieve a WBPTT 20-40 sec above the pre-study WBPTT. The average WBPTT was 104 +/- 15 .8 sec pre-study and 145 +/- 13.3 sec post-study. The average heparin preload was 1,394 +/- 461 units pre-study and 1,888 +/- 440 units post -study. The average heparin infusion rate was 1,085 +/- 311 units/hr p re-study and 1,700 +/- 407 units/hr post-study. The average number of reuses was 6.85 +/- 3.19 pre-study increasing to 8.02 +/- 6.17 post-st udy. In conclusion, increased heparinization (utilizing heparin kineti cs) with a resultant increase in WBPTTS significantly increased dialyz er reuse (p<0.05) in those patients with low reuse (<10.5).