Which condition would indicate withholding systemic heparin during dialysis?

Which condition would indicate withholding systemic heparin during dialysis?

• A. Active bleeding or very high bleeding risk.
• B. Stable coagulation with no risk.
• C. Mild dehydration.
• D. Normal blood pressure.

Answer: (A)

Systemic heparin is given during dialysis to prevent clotting in the extracorporeal circuit, but it increases the risk of bleeding. When there is active bleeding or a very high risk of bleeding, withholding heparin protects the patient from further hemorrhage. In such cases, alternative approaches like saline flushes or regional anticoagulation may be used to keep the dialysis circuit from clotting while avoiding systemic anticoagulation. The other scenarios—stable coagulation with no bleeding risk, dehydration, or normal blood pressure—do not inherently require stopping heparin, since they don’t indicate an elevated bleeding risk.

Systemic heparin is given during dialysis to prevent clotting in the extracorporeal circuit, but it increases the risk of bleeding. When there is active bleeding or a very high risk of bleeding, withholding heparin protects the patient from further hemorrhage. In such cases, alternative approaches like saline flushes or regional anticoagulation may be used to keep the dialysis circuit from clotting while avoiding systemic anticoagulation. The other scenarios—stable coagulation with no bleeding risk, dehydration, or normal blood pressure—do not inherently require stopping heparin, since they don’t indicate an elevated bleeding risk.