Use of heparin versus citrate in hemodialysis catheter: a systematic review

• Autor(a) principal: Oliveira, Lucas Villasboas de
• Data de Publicação: 2022
• Outros Autores: Ferreira, Sarah Oliveira Santos, Mello, Bianca Andrade, Khouri, Nadia de Andrade
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Revista Baiana de Saúde Pública (Online)
• Texto Completo: https://rbsp.sesab.ba.gov.br/index.php/rbsp/article/view/3788
• topic: Cateter de diálise renal; Cateter de hemodiálise; Diálise renal; Heparina; Infecções relacionadas a cateter; Catéter de diálisis renal; Catéter de hemodiálisis; Diálisis renal; Heparina; Infecciones relacionadas con el catéter; Catheter renal dialysis; Catheter hemodialysis; Renal dialysis; Heparin; Catheter-related infections

As the most used solution to seal hemodialysis catheters, heparin use is associated with local and systemic complications. Citrate solution emerges as an alternative due to its anticoagulant effects. This systematic review sought to evaluate the risk of catheter-related bloodstream infection using heparin compared to citrate lock solution. Based on the PRISMA protocol and PICO strategy, data were collected from the Medline, Lilacs and Scielo databases. The search strategy included randomized clinical trials that compared heparin versus citrate as lock solution associated with catheter-related bloodstream infection. Of the 1,204 articles identified, 33 were selected after reading tittles and abstract. After applying the exclusion criteria, four papers were included for review. Primary outcome was catheter-related bloodstream infection. Weijmer et al. observed a reduction in the citrate group. In turn, Barcellos et al. showed opposite results using a multivariate model. Power et al. found no difference between groups and Winnet et al. favored the citrate group using subgroup analysis. Results on the difference between citrate versus heparin in reducing catheter-related bloodstream infection were inconclusive. Further studies using a bigger population and standardized citrate or heparin solution are needed.