Hi all. We have a patient with HIT and a catheter and our MD wants to use a sodium citrate solution to pack the lumens instead of heparin. I'm having a lot of trouble finding a company that makes it for this purpose. So far the only thing close was by a plasma pheresus company called Fenwal (formerly part of Baxter).
FYI, I'm not talking about citric acid you get as a powder or liquid for descaling/disinfection. I'm talking about a sterile solution of sodium citrate buffered with citric acid. I've seen it in 250ml bags.
Question 1: Are any of your clinics using this? Question 2: Where are you getting it from and can I have some contact info.
I am a dialysis patient who has received sodium citrate blocks a few times in two different units: Davita, Puyallup, WA and also Northwest Kidney Center in Auburn, WA. I'm sure they would tell you where they get it.
yes we have been using NaCitrate for some time now instead of the costly Cathflo activase and for patients with an allergy to heparin. It works great and if accidentally infused it doesn't hurt the patient. We order ours from MetroMedical under anticoagulants.
Sounds like a great idea, as heparin dwells make no sense and is costly to boot. Heparin must be activated by the liver to be affective. Therefore having it sit dormant in the catheter make us feel better but does little to prevent clotting. If anything it contributes to heparin induced throcytopenia due to leakage of the heparin between treatments. I also feel that the routine use of Cath Flo as a dwell is a fiscal nightmare at $120 a treatment.