A recent randomized trial published in NEJM Jan 2011 compares tpa(1mg in each lumen) weekly as catheter lock in dialysis catheters to heparin three times a week( 5000units each week) and 6 month follow up.The main points indicate:
20% malfunction of catheter in tpa group, 34% malfunction in heparin group
4.5% bacteremia in tpa group, 13% in heparin group
Bleeding was similar in both groups
In conclusion, the authors suggest that tpa is a safer bet: in terms of infection and malfunction risk. Bleeding risk no difference.
Take a look at the article and commentary below:
Ref:
http://www.ncbi.nlm.nih.gov/pubmed/16608513
http://www.nejm.org/doi/full/10.1056/NEJMoa1011376
http://www.nejm.org/doi/full/10.1056/NEJMe1013952
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