(no subject)

[KTMOHN]

In a message dated 6/1/2006 5:24:12 P.M. Pacific Standard Time, [EMAIL PROTECTED] writes: We started using citrate probably four years ago on a specific group of patients.  Any patient that had any evidence of HIT, or an issue of bleeding, low platelets, etc.  We used it when we do CRRT, but never as a dwell. CRRT is a continuous renal replacement so there is never any dwell time with the catheters.  They come off when they are better or it is unsuccessful. I believe the longest we ran it was almost 3 weeks.  It is very labor intensive and required 1.5 nurse to one patient at a minimum.  It also requires frequent monitoring of the patients Ca and the Ca in the machine.  To that end we had to have a lab on the unit and we trained the resp therapist to run the blood.  Citrate binds Ca so you had to infuse a Ca drip.  There are hourly adjustments to the dialysate, the machine, the Ca drip, everything almost. It is a delicate balance but we have had good success. I worked CCU for a number of years and could dig up all my literature on it if you are interested.    Marcia Erickson  IVT  Stormont-Vail Healthcare [EMAIL PROTECTED]  -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Gwen Irwin Sent: Tuesday, May 30, 2006 7:05 PM To: [EMAIL PROTECTED] Subject: Sodium citrate Is anyone using sodium citrate instead of heparin?  I thought it was no longer available, but recently had nephrologist insist on it being used in hemodialysis catheter.  Pharmacy is checking on it for me, but I actually thought you would be faster!   Are there studies about the efficacy of it, if it is still in use?  If you are using it, what do you think about it?  Is it part of your policy that it can be used or does each situation require a written doctor's order?   Thanks. Gwen Irwin Austin, Texas ************************************************************************************************   The information transmitted in this e-mail and in any replies and forwards are for the sole use of the above individual(s) or entities and may contain proprietary, privileged and/or highly confidential information.  Any unauthorized dissemination, review, distribution or copying of these communications is strictly prohibited.  If this e-mail has been transmitted to you in error, please notify and return the original message to the sender immediately at the above listed address.  Thank you for your cooperation.   ******************************************************* Hi-In Las Vegas-we use Refluden- on any patient with a Heparin senstivity.  No increase in acuity.  The Refluden is used after the dialysis to pack the catheter.  I never thought to ask what they use during dialysis-but I will in the future. Thanks for the interesting question-Kathy Mohn-