| Huang, Yen-fang) |
------>authors3_c=??? ------>paper_class1=1 ------>Impact_Factor=None ------>paper_class3=1 ------>paper_class2=1 ------>vol=9 ------>confirm_bywho=tlc ------>insert_bywho=lcpan ------>Jurnal_Rank=None ------>authors4_c=??? ------>comm_author= ------>patent_EDate=None ------>authors5_c= ------>publish_day=1 ------>paper_class2Letter=None ------>page2=721 ------>medlineContent= ------>unit=D0700 ------>insert_date=20060502 ------>iam=3 ------>update_date=None ------>author=??? ------>change_event=6 ------>ISSN= ------>authors_c=??? ------>score=-159 ------>journal_name=???? ------>paper_name=??2003??15-49???????????? ------>confirm_date=20081209 ------>tch_id=087005 ------>pmid=17018541 ------>page1=713 ------>fullAbstract=BACKGROUND: Central venous catheters (CVCs) continue to be used at a high rate for dialysis access and are frequently complicated by thrombus-related malfunction. Prophylactic locking with an anticoagulant, such as heparin, has become standard practice despite its associated risks. Trisodium citrate (citrate) 4% is an alternative catheter locking anticoagulant. METHODS: The objective was to prospectively study the clinical effectiveness, safety and cost of citrate 4% vs heparin locking by comparing rates of CVC exchanges, thrombolytic use (TPA) and access-associated hospitalizations during two study periods: heparin period (HP) (1 June 2003-15 February 2004) and Citrate Period (CP) 15 March-15 November 2004. Incident catheters evaluated did not overlap the two periods. RESULTS: There were 176 CVC in 121 patients (HP) and 177 CVC in 129 patients (CP). The event rates in incident CVC were: CVC exchange 2.98/1000 days (HP) vs 1.65/1000 days (CP) (P = 0.01); TPA use 5.49/1000 (HP) vs 3.3/1000 days (CP) (P = 0.002); hospitalizations 0.59/1000 days (HP) vs 0.28/1000 days (CP) (P = 0.49). There was a longer time from catheter insertion to requiring CVC exchange (P = 0.04) and TPA (P = 0.006) in the citrate compared with the heparin lock group. Citrate locking costs less than heparin locking but a formal economic analysis including indirect costs was not done. CONCLUSION: Citrate 4% has equivalent or better outcomes with regards to catheter exchange, TPA use and access-related hospitalizations compared with heparin locking. It is a safe and less expensive alternative. Randomized trials comparing these anticoagulants with a control group would definitively determine the optimal haemodialysis catheter locking solution. ------>tmu_sno=None ------>sno=13586 ------>authors2=Huang, Yih-shin ------>authors3=Pan, Li-chern ------>authors4=Hsieh, Ya-wen ------>authors5= ------>authors6= ------>authors6_c= ------>authors=Huang, Yen-fang) ------>delete_flag=0 ------>SCI_JNo=None ------>authors2_c=??? ------>publish_area=0 ------>updateTitle=Trisodium citrate 4%--an alternative to heparin capping of haemodialysis catheters. ------>language=1 ------>check_flag=None ------>submit_date=None ------>country=None ------>no=6 ------>patent_SDate=None ------>update_bywho=None ------>publish_year=2005 ------>submit_flag=None ------>publish_month=11 |