무헤파린 혈액투석시 지속적 생리식염수 주입법과 간헐적 생리식염수 주입법의 비교연구 = Comparative Research of the Continuous normal saline infusion and the Intermittent normal saline infusion in Heparin-free hemodialysis patients.

다국어 초록 (Multilingual Abstract)

● Authors: RNs of the Renal unit, Seoul National University Hospital, Korea
● Purpose: Conventionally the anticoagulants has been used in the case of extracoporeal circulation like hemodialysis. Heparin use may increase bleeding tendency. To diminish the bleeding tendency, various heparinization methods have been used such as regional heparinization, low-dose heparinization, and heparin-free method. Despite their benefits, they provoke problems such as the blood loss related to dialyzer clot, the necessity of ultrafiltration due to excessive normal saline infusion etc. The purpose of this research is to find safe and more efficient ways of hemodialysis practice, especially for those who have active or potential problem of bleeding.
● Design: This study is quasi experimental research using repeated counter balancing measure design.
● Methods: From September first 1999 to October 23rd 1999, we completed the study at the renal unit of Seoul National University Hospital. We compared the dialyzer clot rates between the continuous normal saline infusion and the intermittent normal saline infusion, for ten patients in heparin-free hemodialysis. And the data of two different methods were analyzed by Wilcoxon Rank sums 2-sample test.
● Results: The study reported the rates of 9.75 and 11.25 respectivly for the continuous normal saline infusion and the intermittent normal saline infusion in average of three hour period of heparin- free hemodialysis. The Z parameter indicated 0.5316. This result implies that the hypothesis was not supported that there would be a significant rate difference in the two tested methodologies. The clot rates of the four hour period of hearin-free hemodialysis for the continuous normal saline infusion and the intermittent normal saline infusion were 10.70 and 10.30 respectivly which were significantly higher than alpha value 0.5. This study tested statistically low sample size due to the limited number of patients, therefore the following research would be required to increase the number of sample size to improve.
● Implication: From now on, in clinical implication, considering the results between the three-hour period's and the four-hour period's, as more efficient and safer heparin-free hemodialysis methodology, the continuous normal saline infusion with appropriate blood flow rate and duration will be recommended.