Questions About PD
There are various protocols but our center we have used the protocol from the PD access guide 2022 from Baxter.
Procedure to instill tPA:
1. Estimate total volume of catheter and transfer set
2. Reconstitute tPA at dilution of 1mg/mL
3. Aspirate contents of catheter
4. Connect syringe to transfer set and inject 110% of calculated volume of tPA
5. Allow tPA to remain in catheter for 1-2 hours
6. Aspirate tPA from catheter
7. With 60 mL syringe, briskly irrigate the catheter with saline to determine patency and
dislodge any fibrin clots
Zorzanello M, Fleming W, Prowant B. Use of tissue plasminogen activator in peritoneal dialysis catheters: a literature review and one center’s experience. Neph Nurs J 2004;31:534-7.
Crabtree JH. Rescue and salvage procedures for mechanical and infectious complications of peritoneal dialysis. Int J Artif Organs. 2006; 29:67-84.