Heparin is a drug that is used to prevent blood clotting. A heparin lock flush is utilized in hospital settings to keep intravenous (IV) catheters open and freely floating. A heparin flush does not treat or prevent clotting within the body but instead is regionalized at the IV insertion site. There are a few reasons to seek alternative treatments for a heparin flush.
Reasons to Seek Alternatives
While a heparin lock flush is the primary anticoagulant used for catheter flow, according to the Mayo Clinic, there are reasons to seek alternatives. You may be allergic to the drug heparin, which would require an alternative unless you are able to develop a desensitization. If you are having frequent heparin locks due to treatments such as dialysis or chemotherapy, you may develop an antibody to heparin. This could render the heparin lock ineffective and lead to a dangerous situation while receiving treatment. Some patients do develop what is called a heparin-induced thromobcytopenia (HIT), a low platelet count resulting from heparin use.
One of the many reasons patients are seeking alternatives to heparin lock flushes is a Baxter recall of the drug in 2008. In cooperative efforts with the FDA, Baxter conducted a widespread recall because there was an increase in reports of adverse affects when using the drug. While ample supplies of heparin are available through other suppliers, you may have concerns that lead you to discuss options with your doctor.
Alternative Drugs
Your doctor may stop your heparin lock flush if you have any of the concerns mentioned above, but he will need to replace heparin with a different anticoagulant to ensure your health and safety during your medical procedures.
UAB Coagulation Service discusses the use of two direct thrombin inhibitors should you develop an HIT. The two anticoagulants recommended are argatroban and lepirudin. A study by the University of California at Davis reviewed the effectiveness of saline flushes, citrasate or ACD-A as alternative flushes. This study found that clotting occurred in 26 percent of patients who have a saline flush, and a clot rate of 14 percent in those with citrasate. ACD-A is a combination of citrasate and calcium gluconate and had the best success rate of the alternative flushes reviewed: a 2 percent clotting rate.
Talk to your doctor about your specific condition, risks and needs in order to find the best alternative for you.
Tags: heparin lock, heparin lock flush, lock flush, alternative flushes, citrasate ACD-A, have concerns, heparin flush