Baptistella Conrado Dias Pacheco Annicchino, Batista Santini Pedro Henrique, de Almeida Mendes Cynthia, Guerra João Carlos de Campos, Pereira Francisco Neves, de Aranda Valdir Fernandes, Wolosker Nelson
Departament of Vascular Surgery, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Departament of Vascular Surgery, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Ann Vasc Surg. 2019 Nov;61:165-169. doi: 10.1016/j.avsg.2019.04.023. Epub 2019 Jul 20.
The aim of this study is to analyze whether heparin, used as a lock in fully implantable catheter for chemotherapy (portocath), maintains its activity even if it remains in the catheter for a long period of time.
According to the institutional protocol, all catheters routinely use the lock solution with 3 mL of heparinized solution after chemotherapy and the time interval between each change as lock in the catheters studied ranged from 7 to 30 days. A total of 25 blood samples from 22 patients with 6 types of neoplasia on chemotherapy or not were collected according to routine, and the 10 mL of liquid contained in the first aspirated reservoir/catheter (corresponding to the lock of the last section), were sent for laboratory analysis for prospectively studied with the following tests: anti-Xa, partially activated thromboplastin time (APTT), thrombin time (TT), reptilase, and thromboelastogram.
Heparin activity was found in 96% of the anti-Xa and APTT tests. In relation to TT, 92% presented activity. The reptilase test was performed on 24 samples with significant time reduction in all of them. In the INTEM stage, the thromboelastometry test showed activity in 92% of samples and in the HEPTEM phase there was reduction in time in all samples. In all samples, the heparin activity was found to be independent of the time of use.
We can conclude that lock of heparinized solution used in our service in fully implantable central venous catheters for chemotherapy was maintained with active heparin even after a long period of time (up to 30 days), demonstrating that the half-life of the substance within the catheter is greater than its plasma half-life.
本研究旨在分析用于化疗的完全植入式导管（输液港）封管的肝素，即使在导管内留置很长时间，是否仍能保持其活性。
根据机构方案，所有导管在化疗后常规使用含3 mL肝素化溶液的封管液，所研究导管每次封管更换的时间间隔为7至30天。按照常规从22例患有6种肿瘤（无论是否接受化疗）的患者中采集了25份血样，并将首次抽出的储液器/导管内的10 mL液体（对应于最后一段的封管液）送去实验室分析，以便通过以下检测进行前瞻性研究：抗Xa、部分活化凝血活酶时间（APTT）、凝血酶时间（TT）、蛇静脉酶和血栓弹力图。
在96%的抗Xa和APTT检测中发现肝素活性。关于TT，92%呈现活性。对24份样本进行了蛇静脉酶检测，所有样本的时间均显著缩短。在INTEM阶段，血栓弹力测定检测显示92%的样本有活性，在HEPTEM阶段，所有样本的时间均缩短。在所有样本中，发现肝素活性与使用时间无关。
我们可以得出结论，我们科室用于化疗的完全植入式中心静脉导管中使用的肝素化溶液封管，即使在很长一段时间（长达30天）后仍保持有活性的肝素，表明该物质在导管内的半衰期大于其血浆半衰期。
