[Home ] [Archive]   [ فارسی ]  
:: Main :: About :: Current Issue :: Archive :: Search :: Submit :: Contact ::
Main Menu
Home::
Journal Information::
Indexing Sources::
Editorial Board::
Executive Members::
Articles Archive::
Instruction to Authors::
Peer-Review::
Contact Us::
Site Facilities::
::
Search in website

Advanced Search
Receive site information
Enter your Email in the following box to receive the site news and information.
:: Volume 22, Issue 1 (3-2020) ::
J Gorgan Univ Med Sci 2020, 22(1): 27-34 Back to browse issues page
Effect of intermittent normal saline bolus on the quality of clot formation in the dialyzer and the venous chamber of dialysis circuit: A randomized clinical trial
Mitra Shirashiani1 , Gholeamreza Roshandel2 , Homeira Khoddam * 3
1- M.Sc in Critical Care Nursing, School of Nursing and Midwifery, Golestan University of Medical Sciences, Gorgan, Iran.
2- Epidemiologist, Associate Professor, Golestan Research Center of Gastroenterology and Hepatology (GRCGH), Gorgan, Iran.
3- Ph.D in Nursing, Assistant Professor, Nursing Research Center, Golestan University of Medical Sciences, Gorgan, Iran , khoddam@goums.ac.ir
Abstract:   (2445 Views)
Background and Objective: The prevention of clot formation during hemodialysis improves the effectiveness of treatment by maintaining patency in the dialyzer. This study was done to evaluate the effect of intermittent bolus of normal saline on the quality of clot formation in venous chamber and dialyzer.
Methods: In this clinical trial study, 51 eligible patients were divided into intervention (n=26) and control (n=25) groups. Patients in the control group received routine care and the intervention group received 100ml of normal saline, each hour, as an intermittent bolus, during 4 hours of dialysis beside the routine care. After three consecutive hemodialysis sessions (first round), all patients received routine care to clear the intervention effect (washout period). Then, patients crossed over from intervention group to control and vice versa. At the end of each session, the quality of clot formation in intravenous chamber and dialyzer was recorded and analyzed.
Results: The venous chamber of dialysis circuit in 74% of patient in intervention group no clot was formed, whereas in 58% of patient in control group it contained fibrous ring (P<0.05). After intervention, dialyzer of 68% of patients in intervention group, were free of clot, whereas in control group only 16% of dialyzers were free of clots (P<0.05).
Conclusion: Using intermittent bolus of normal saline during hemodialysis can reduce the risk of clot formation in venous chamber and dialyzer.
Keywords: Renal Dialysis, Blood Coagulation, Sodium Chloride
Article ID: Vol22-04
Full-Text [PDF 233 kb]   (13017 Downloads)    
Type of Study: Original Articles | Subject: Nursing
References
1. Malekmakan L, Tadayon T, Roozbeh J, Sayadi M. End-stage Renal Disease in the Middle East: A Systematic Review and Meta-analysis. Iran J Kidney Dis. 2018 Jul; 12(4): 195-203.
2. Luyckx VA, Tonelli M, Stanifer JW. The global burden of kidney disease and the sustainable development goals. Bull World Health Organ. 2018 Jun; 96(6): 414-22D. doi: 10.2471/BLT.17.206441
3. El-Sheikh M, El-Ghazaly G. Assessment of hemodialysis adequacy in patients with chronic kidney disease in the hemodialysis unit at Tanta UniversityHospital in Egypt. Indian J Nephrol. 2016 Nov-Dec; 26(6): 398-404. doi: 10.4103/0971-4065.168141
4. McCullough KP, Morgenstern H, Saran R, Herman WH, Robinson BM. Projecting ESRD incidence and prevalence in the United States through 2030. J Am Soc Nephrol. 2019 Jan; 30(1):127-35. doi: 10.1681/ASN.2018050531
5. Aghighi M, Mahdavi-Mazdeh M, Zamyadi M, Heidary Rouchi A, Rajolani H, Nourozi S. Changing epidemiology of end-stage renal disease in last 10 years in Iran. Iran J Kidney Dis. 2009 Oct; 3(4): 192-96.
6. Daugirdas JT, Depner TA, Inrig J, Mehrotra R, Rocco MV, Suri RS, et al. KDOQI clinical practice guideline for hemodialysis adequacy: 2015 update. Am J Kidney Dis. 2015 Nov; 66(5): 884-930. doi: 10.1053/j.ajkd.2015.07.015
7. Collins AJ, Foley RN, Gilbertson DT, Chen SC. United States Renal Data System public health surveillance of chronic kidney disease and end-stage renal disease. Kidney Int Suppl (2011). 2015 Jun; 5(1): 2-7. doi: 10.1038/kisup.2015.2
8. Port FK, Held PJ. The US Renal Data System at 30 Years: A Historical Perspective. Am J Kidney Dis. 2019 Apr; 73(4): 459-61. doi: 10.1053/j.ajkd.2018.11.003
9. Asayesh H, Peykari N, Pavaresh-Masoud M, Esmaeili Abdar M, Tajbakhsh R, Mousavi SM, et al. Dermatological manifestations in hemodialysis patients in Iran: A systematic review and meta-analysis. J Cosmet Dermatol. 2019 Feb; 18(1): 204-11. doi: 10.1111/jocd.12531
10. Naghibi M, Mojahedi MJ, Jarrahi L, Emadzadeh A, Ahmadi R, Emadzadeh M, et al. Prevalence of chronic kidney disease and its risk factors in Gonabad, Iran. Iran J Kidney Dis. 2015 Nov; 9(6): 449-53.
11. Dehvan F, Monjazebi F, Erfani Khanghahi M, Mohammadi H, Ghanei Gheshlagh R, Kurdi A. Adequacy of Dialysis in Iranian Patients Undergoing Hemodialysis: A Systematic Review and Meta-Analysis. Nephro Urol Mon. 2018; 10(5): e82235.
12. Daugirdas JT, Blake PG, Ing TS. Handbook of dialysis. 5th ed. Philadelphia: Lippincott Williams & Wilkins. 2015; pp: 55-59.
13. Geradin C, Debiais C, Vinsonneau C. Intermittent Techniques for Acute Dialysis. In: Ronco C, Bellomo R, Kellum JA, Ricci Z, editors. Critical Care Nephrology. 3rd ed. Philadelphia: Content Repository Only. 2019; pp: 905-8.e1.
14. Nissenson AR, Fine RE. Handbook of Dialysis Therapy E-Book: Elsevier Health Sciences. 2016.
15. Baldwin I. Nursing Strategies to Prevent Coagulation of the Extracorporeal Circuit. In: Ronco C, Bellomo R, Kellum JA, Ricci Z, editors. Critical Care Nephrology. 3rd ed. Philadelphia: Content Repository Only. 2019; pp: 1024-8.e1.
16. Zimbudzi E. Intermittent saline flushes or continuous saline infusion: what works better when heparin-free dialysis is recommended? Int J Nephrol Renovasc Dis. 2013; 6: 65-69. doi: 10.2147/IJNRD.S43252
17. Sagedal S, Hartmann A, Sundstrøm K, Bjørnsen S, Brosstad F. Anticoagulation intensity sufficient for haemodialysis does not prevent activation of coagulation and platelets. Nephrol Dial Transplant. 2001 May; 16(5): 987-93. doi: 10.1093/ndt/16.5.987
18. Davenport A. Optimization of heparin anticoagulation for hemodialysis. Hemodial Int. 2011 Oct;15 Suppl 1: S43-48. doi: 10.1111/j.1542-4758.2011.00601.x
19. Dirkes S, Wonnacott R. Continuous renal replacement therapy and anticoagulation: What Are the Options? Crit Care Nurse. 2016 Apr; 36(2): 34-41. doi: 10.4037/ccn2016623
20. KesslerM, Moureau F, Nguyen P. Anticoagulation in Chronic Hemodialysis: Progress Toward an Optimal Approach. Semin Dial. 2015 Sep-Oct; 28(5): 474-89. doi: 10.1111/sdi.12380
21. Skagerlind MSE, Stegmayr BG. An evaluation of four modes of low-dose anticoagulation during intermittent haemodialysis. Eur J Clin Pharmacol. 2018 Mar; 74(3): 267-74. doi: 10.1007/s00228-017-2389-x
22. Kessler M, Gangemi C, Gutierrez Martones A, Lacombe JL, Krier-Coudert MJ, Galland R, et al. Heparin-grafted dialysis membrane allows minimal systemic anticoagulation in regular hemodialysis patients: a prospective proof-of-concept study. Hemodial Int. 2013 Apr; 17(2): 282-93. doi: 10.1111/j.1542-4758.2012.00733.x
23. Guéry B, Alberti C, Servais A, Harrami E, Bererhi L, Zins B, et al. Hemodialysis without Systemic Anticoagulation: A Prospective Randomized Trial to Evaluate 3 Strategies in Patients at Risk of Bleeding. PLoS One. 2014 May; 9(5): e97187. doi: 10.1371/journal.pone.0097187
24. Yixiong Z, Jianping N, Yanchao L, Siyuan D. Low dose of argatroban saline flushes anticoagulation in hemodialysis patients with high risk of bleeding. Clin Appl Thromb Hemost. 2010 Aug; 16(4): 440-45. doi: 10.1177/1076029609334628
25. Ashvandi K, Cheraghi MA. [Comparing of two priming methods of hemodialysis set by simple normal saline and normal saline containing heparin soultions on the amount of clot formation in dialyzor duringhemodialysis]. J Shahid Sadoughi Uni Med Sci. 2002; 10(3): 10-15. [Article in Persian]
26. Dehghani K, Nasiriani K, Babaei H. [Comparison of three heparinization methods of hemodialysis set on coagulation condition and dialysis efficacy in patient undergoing hemodialysis]. J Shahid Sadoughi Uni Med Sci. 2014 May-Jun; 22(2): 1090-100. [Article in Persian]
27. Panphanpho S, Naowapanich P, Ratanarat R. Use of saline flush to prevent filter clotting in continuous renal replacement therapy without anticoagulant. J Med Assoc Thai. 2011 Feb; 94 (Suppl 1): S105-10.
28. Sagedal S, Hartmann A, Osnes K, Bjørnsen S, Torremocha J, Fauchald P, et al. Intermittent saline flushes during haemodialysis do not alleviate coagulation and clot formation in stable patients receiving reduced doses of dalteparin. Nephrol Dial Transplant. 2006 Feb; 21(2): 444-49. doi: 10.1093/ndt/gfi203
29. Sahota S, Rodby R. Inpatient hemodialysis without anticoagulation in adults. Clin Kidney J. 2014 Dec; 7(6): 552-56. doi: 10.1093/ckj/sfu114
30. Kazemi M, Rafiei GR, Karimi S. Comparing the effects of three heparinization methods of hemodialysis set on the amount of clot formation during hemodialysis. J Kerman Univ Med Sci. 2005; 12(3): 195-201.
31. Farhadi M, Dadgari F, Farsi Z, Dadgari A. [The effect of priming with recirculation of normal saline method on urea reduction ratio among dialysis patients]. Milit Care Sci. 2015; 2(2): 87-95. [Article in Persian]
Send email to the article author


XML   Persian Abstract   Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Shirashiani M, Roshandel G, Khoddam H. Effect of intermittent normal saline bolus on the quality of clot formation in the dialyzer and the venous chamber of dialysis circuit: A randomized clinical trial. J Gorgan Univ Med Sci 2020; 22 (1) :27-34
URL: http://goums.ac.ir/journal/article-1-3699-en.html


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Volume 22, Issue 1 (3-2020) Back to browse issues page
مجله دانشگاه علوم پزشکی گرگان Journal of Gorgan University of Medical Sciences
Persian site map - English site map - Created in 0.05 seconds with 36 queries by YEKTAWEB 4652