i've talk with some techs. and some tell me that they recitculate the dialyzer with saline and 2000 u. of heparin for 10 minutes after the treatment. others tell me that they do not put any heparine, just saline.
any input? what is the best way to do it and why?.
thanks

We used saline and 2 - 5 cc heparin to recirculate following the treatment and found our re-use numbers going up significantly. I am not sure what the "best" way to do it is, I only know what worked for us. I would suggest you try it both ways and see which has a better effect. Heparin is pretty cheap, so an extra 5 cc's isn't going to break the bank...
Ruth

do it if you have a reuse program 10cc of heparin if not just toss the dialyzer
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We tried different post tx re-circulation heparin and saline combinations at our clinic and the results are always the same. Heparin is an anti-coagulant it will not dissolve clots that are already formed. It was more adventageous for us to increase the hourly heparin during the tx or use throw away dialyzers for pt's with inadequate re-use numbers

Have you tried heparinising the patient 3 to 5 minutes before the treatment is initiated?

Some people will just get poor reuse (due to hematcrit, access type, etc. ) also staff play an important role. I don't agree with flushing the dialyzer for ten minutes after the treatment, it just seems too time consuming, why not just crank the blood pump up and flush remaining saline/heparin through the dialyzer (it works just as well). Also you can prime with a small amount of heparin to "coat" fibers. I have seen it done just about every imagineable way and it's not that any one is better than the other, it's just different viewpoints and sometimes "what we are used to".