Uk, Tpa

Specialties MICU

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What do you use to reverse coagulation of central line catheters?

What do you use to reverse coagulation of central line catheters?

Hello-

I'm confused about the question...do you mean if a patient has elevated coags what product is used to "normalize"?

At my facility if someone has an elevated PT/INR we always give FFP based on the coags and then do the procedure within 1/2 hour after the infusion is completed. However if a patient has a "shocky" liver or has a clotting malfunction we opt to place a femoral line. The policy in our facility is that any lines (excluding IABP) that is placed in the groin has to be rotated or changed over a wire within 48 hours of insertion.

We have circumstances as all hospitals do that are "exceptions" to the rule. For example we had a CABG/MVR 76 year old male who went "bad" and had numerous lines that were not being rotated per policy--> R fem IABP, L fem art/venous sheaths, R IJ swan/TLC (both in same point of insertion) and a L SC shiley catheter for CVVH. On multiple vasopressors, ABX, diuretics and xigris all this with an open chest!!! Needless to say this was one of our few 1:1 patients.

What's procedure at your facility?

LCRN

I was asking about clotted lines.

Specializes in Surgical.

activase, or TPA. Just instill and leave for hour then try to aspirate...ya da ya da

I'm sorry,I completely misunderstood your question the night that I read it. Although when I go back and look at it now, it makes perfect sense.

We use 2 cc of alteplase in each port. We instill the med into the catheter (usually with an insulin syringe or 3 cc) and wait 1/2 hour. Then we attempt to aspirate out the alteplase and flush vigorously with heparinized saline.

This is usually effective. Sorry about the misunderstanding.

LCRN

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