Biomaterial Database

Discard volumes necessary for clinically useful coagulation studies from heparinized Hickman catheters. 1996

D J Mayo, and E P Dimond, and W Kramer, and M K Horne

Critical Care, Heart, Lung, Blood, and Cancer Nursing Service, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, MD, USA.

OBJECTIVE Determine the blood volume that must be wasted to obtain a clinically useful prothrombin time (PT), activated partial thromboplastin time (APTT), and fibrinogen concentration for blood drawn from a heparinized (2.5 ml of 100 units/ml), double-lumen venous catheter. METHODS Prospective, nonrandomized study comparing test results obtained from blood samples drawn through the catheters with those obtained via peripheral venipuncture. Patients acted as their own control. METHODS Inpatient and outpatient units of a cancer research center located in a mid-Atlantic city in the United States. METHODS Twenty double-lumen 10 Fr. Hickman catheters (Bard Access Systems, Salt Lake City, UT) were studied in 20 adult patients with cancer who had no history of coagulation disorders. METHODS Samples were collected from the red lumen of 20 heparinized, double-lumen Hickman catheters after 5, 10, 15, 20, and 25 ml of blood first were discarded. PTs, APTTs, and fibrinogen concentrations were measured on each sample. The results were compared with those derived from a simultaneously obtained peripheral blood sample. METHODS PT, APTT, and fibrinogen values of blood samples after 5, 10, 15, 20, and 25 ml discards and PT, APTT, and fibrinogen of peripheral blood samples. RESULTS The coagulation results using peripheral blood were always within the normal range except for one slightly elevated APTT. After 25 ml of discard, all of the PTs and fibrinogen concentrations and 95% of the APTTs of catheter blood were within the normal range and therefore clinically useful. CONCLUSIONS Clinically useful PTs, APTTs, and fibrinogen concentrations often can be derived with catheter-drawn blood when the objective is to confirm normal coagulation. However, because it is very difficult to obtain heparin-free samples through heparinized, double-lumen Hickman catheters, peripheral blood should be drawn for coagulation testing when a totally heparin-free sample is needed to make a critical clinical decision. CONCLUSIONS These findings provide important information for practice when nurses have to decide whether to draw coagulation tests through a heparinized catheter. Further research is needed with larger samples in varied populations (e.g., pediatrics) to study catheters made of different materials and of different calibers.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D009369	Neoplasms	New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms.	Benign Neoplasm,Cancer,Malignant Neoplasm,Tumor,Tumors,Benign Neoplasms,Malignancy,Malignant Neoplasms,Neoplasia,Neoplasm,Neoplasms, Benign,Cancers,Malignancies,Neoplasias,Neoplasm, Benign,Neoplasm, Malignant,Neoplasms, Malignant
D011446	Prospective Studies	Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.	Prospective Study,Studies, Prospective,Study, Prospective
D001780	Blood Coagulation Tests	Laboratory tests for evaluating the individual's clotting mechanism.	Coagulation Tests, Blood,Tests, Blood Coagulation,Blood Coagulation Test,Coagulation Test, Blood,Test, Blood Coagulation
D001800	Blood Specimen Collection	The taking of a blood sample to determine its character as a whole, to identify levels of its component cells, chemicals, gases, or other constituents, to perform pathological examination, etc.	Blood Specimen Collections,Collection, Blood Specimen,Collections, Blood Specimen,Specimen Collection, Blood,Specimen Collections, Blood
D002405	Catheterization, Central Venous	Placement of an intravenous CATHETER in the subclavian, jugular, or other central vein.	Central Venous Catheterization,Venous Catheterization, Central,Catheterization, Central,Central Catheterization,Catheterizations, Central,Catheterizations, Central Venous,Central Catheterizations,Central Venous Catheterizations,Venous Catheterizations, Central
D002406	Catheterization, Peripheral	Insertion of a catheter into a peripheral artery, vein, or airway for diagnostic or therapeutic purposes.	Arterial Catheterization, Peripheral,Catheterization, Bronchial,Catheterization, Peripheral Arterial,Catheterization, Peripheral Venous,Peripheral Catheterization,Venous Catheterization, Peripheral,Bronchial Catheterization,PICC Line Catheterization,PICC Line Placement,PICC Placement,Peripheral Arterial Catheterization,Peripheral Venous Catheterization,Peripherally Inserted Central Catheter Line Insertion,Arterial Catheterizations, Peripheral,Bronchial Catheterizations,Catheterization, PICC Line,Catheterizations, Bronchial,Catheterizations, PICC Line,Catheterizations, Peripheral,Catheterizations, Peripheral Arterial,Catheterizations, Peripheral Venous,PICC Line Catheterizations,PICC Line Placements,PICC Placements,Peripheral Arterial Catheterizations,Peripheral Catheterizations,Peripheral Venous Catheterizations,Placement, PICC,Placement, PICC Line,Placements, PICC,Placements, PICC Line,Venous Catheterizations, Peripheral
D002408	Catheters, Indwelling	Catheters designed to be left within an organ or passage for an extended period of time.	Implantable Catheters,In-Dwelling Catheters,Catheter, In-Dwelling,Catheter, Indwelling,Catheters, In-Dwelling,In Dwelling Catheters,In-Dwelling Catheter,Indwelling Catheter,Indwelling Catheters
D005260	Female		Females