Key result
Venous blood line bolus of enoxaparin significantly increased median post-dialysis anti-factor Xa activity compared to arterial administration (0.31 vs 0.16 IU/ml, p=0.006).
Why the study?
Although venous blood line injection is recommended to prevent initial LMWH loss through dialyzers, LMWH is still frequently injected into the arterial line.
Does enoxaparin administered through the venous blood line improve antifactor Xa activity and prevent clotting compared to arterial blood line administration in hemodialysis patients?
Comparison
Enoxaparin injection via the venous blood line vs arterial blood line
Design
Prospective crossover study
Authors
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Venous enoxaparin may increase aXa activity and overdosing risk in HF-HD/MCO-HD; leaves open route- and modality-specific dosing guidance.
Does enoxaparin administered through the venous blood line improve antifactor Xa activity and prevent clotting compared to arterial blood line administration in hemodialysis patients?
Absolute Event Rate: 0.31% vs 0.16%
p-value: p=0.006
Venous blood line administration of enoxaparin during hemodialysis increases post-dialysis aXa activity compared to arterial administration, which may increase bleeding risk in certain dialysis modalities.
Belmouaz et al. (2022) studied Hemodialysis (n=43). Enoxaparin injection in the venous blood line vs. Enoxaparin injection in the arterial blood line was evaluated on median post-dialysis antifactor Xa (aXa) activity (IU/ml) (p=0.006). Venous blood line bolus of enoxaparin significantly increased median post-dialysis anti-factor Xa activity compared to arterial administration (0.31 vs 0.16 IU/ml, p=0.006).
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