How to prevent clotting of blood in the blood circuit system during hemodialysis?
Heparin is routinely given during the hemodialysis treatment to prevent thrombosis in the extracorporeal circuit. Heparin is usually given as a bolus at the initiation of dialysis, followed by a constant infusion. The initial dose of heparin required is weight based; however, over time, it is individualized for each patient receiving dialysis to prevent complications. The appropriate dose of heparin is generally the amount that prevents clotting in the extracorporeal circuit but, at the same time, does not lead to bleeding from the needle puncture sites for more than 10 minutes after the needles are removed at the end of the hemodialysis treatment. In patients who are at high risk for bleeding, such as in postoperative patients or those with gastrointestinal bleeding, no heparin is given with monitoring of the dialyzer to ensure that it does not clot.