ASDIN Locking Solutions for Hemodialysis Catheters;

There is wide variation in the use of solutions to ‘‘lock’ ’ or fill tunneled central venous catheters for dialysis. Some centers use undiluted heparin concentrations ranging from 1000 to 10,000 U ⁄ml and other centers place from 1000 to 10,000 U per lumen. Based on available evidence, it appears that heparin 1000 U ⁄ml, or 4 % sodium citrate are suitable choices for lock solution to maintain patency of tunneled central venous cathe-ters for dialysis. Risks from systemic anticoagulation are lower with heparin 1000 U ⁄ml and 4 % sodium citrate, compared with higher concentrations of heparin (5000 and 10,000U ⁄ml). The need for use of tissue plasminogen activator for maintain-ing catheter patency is increased by using heparin lock at 1000 U ⁄ml, vs. higher concentrations. Higher concentrations of heparin lock should be reserved for patients who have evi