Abstract
Because central venous catheters often become blocked by clot at their tip despite heparin flushes, a more effective anticoagulant is needed. We hypothesize that lepirudin, a recently introduced protein anticoagulant, might be more effective than heparin because of its tendency to adsorb to silicone, a commonly used catheter material. We preliminarily tested this hypothesis in vitro by measuring residual lepirudin and heparin activity at the tip of a catheter that had been submerged in a flowing stream of water for various periods of time. We observed that lepirudin is less readily removed than heparin from the catheter by fluid washing over it. This “slow-release” property of lepirudin might provide prolonged protection against clot formation at the catheter tip. A clinical trial will be necessary, however, to determine whether this property translates into significant improvement in catheter function.
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Horne, M.K., Inkellis, E. Retention of lepirudin at the tip of a silicone catheter: a better catheter flush solution?. Support Care Cancer 12, 278–281 (2004). https://doi.org/10.1007/s00520-004-0592-7
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DOI: https://doi.org/10.1007/s00520-004-0592-7