patient has history is of HIT , what kind of the anticoagulant can be used for dialysis

[uae808]

Hi , fellows ,

Patient has history is of HIT , what kind of the anticoagulant can be used for dialysis ?

Most our patients use fragmin , can use fragmin for HIT patient?

[MizChelleRN]

This is a great conversation. Not sure either if it "prevents" clotting, but it gives me a chance to clear the drip chambers so I can see what's going on with them. If they are getting thicker, with blood sticking around the walls of the chambers, the saline will wash it out. I like your point with the low platelets, are they really going to clot anyway? And the saline sodium content was a good point.

[MizChelleRN]

Oh and I wanted to mention watching what the kecn is doing with those dialyzer fibers clotting off.

[NurseRies, BSN, RN]

Our patients are on a low sodium diet. They don't even let them have chicken soup or too much cottage cheese, I mean the sodium restriction is almost ridiculous. But it is there for a reason. Did you know that lower sodium decreases inflammation, decreases fluid retention, and also helps ACE inhibitors work better? Some physicians do not even like to use a sodium profile, yes it may prevent cramping, so you can get more fluid off. So you get off 4L of fluid, but by making their base sodium higher, they retain more water after treatment and also are very thirsty. So you're really not doing them any favors. I just really am against giving our patient population more saline then absolutely necessary. I am surprised that more dialysis nurses don't agree.