Six patients did not require any adjustment in their dose of tinzaparin. The remaining 26 patients required adjustments, of which 20 required increments and 6 required reductions.
The visual aspects of the tubing of the extracorporeal circuit and of the dialyser were similar in the two study groups. In the majority of cases this was recorded as either 0, indicating no clotting or very clean, or 1, indicating pink but clean and no clotting.
The time to compression of the vascular access at the end of the haemodialysis session was not different in the two groups. For the entire group, this was 9.5 (+/- 3) minutes (range: 6 - 16) with tinzaparin and 9.5 (+/- 1.8) minutes (range: 5.8 - 16.1) with heparin.
Clotting was observed more frequently with tinzaparin than with standard heparin, although there was a tendency for it to decrease over time. Clots were observed in the arterial and venous bubble traps in 18% (+/- 12%) and 10% (+/- 6%), respectively, of the sessions with tinzaparin, and in 3% (+/- 4%) and 2% (+/- 4%) of the sessions with standard heparin, (p<0.005).
There was no statistically significant difference in the reuse of filters. This was 2.2 with tinzaparin and 3.5 with standard heparin. The maximum reuse numbers achieved were 3.8 with tinzaparin and 5.0 with standard heparin.
However, the total number of dialysers utilised for each period of 4 weeks was 4.7 (+/- 4.2) with tinzaparin and 5.6 (+/- 3.7) with standard heparin, (p<0.005).
In terms of complications, 2 patients in the tinzaparin group and 8 patients in the standard heparin group reported excessive bleeding.
The level of satisfaction for tinzaparin was extremely good for both patients and nurses. Ten patients and 12 nurses were "much more satisfied with tinzaparin than with standard heparin", 8 patients and 8 nurses were "more satisfied", 12 patients and 1 nurse were "equally satisfied", and 0 patients and 0 nurses were "less satisfied" or "much less satisfied" with tinzaparin than with standard heparin. The reason for satisfaction was less bleeding for the patients, and the simplicity and rapidity of administration for the nurses.
The time spent for anticoagulation during the session was 5 minutes with standard heparin without ACTESTER monitoring, 25 to 30 minutes with standard heparin with ACTESTER monitoring, and 1 minute with tinzaparin.