Table 2.

Thrombolytic Regimens.

Type	Dose	Time	Delivery
Nonfunctioning catheter (Qb < 150/200 mL/min or inability to withdraw) (short or long dwell)	Typical dose: 2 mg tPA instillation (1 mg in each lumen) Alternative dose: 2 mg tPA per lumen	30 min after instillation (short dwell) Alternative: wait additional 2 h (long dwell) if 30 min fails28	tPA instilled as dwell for 30-60 min Alternatives: push one-third of dose every 10 min; advance the initial pushed tPA at 10- to 15-min intervals with 0.3 mL saline, or deliver via infusion pump over 30 min
Poor functioning catheter with dialysis stopped	2-4 mg tPA	As above	As above
Poor functioning catheter with dialysis ongoing (eg, Qb > 200 mL/min) but frequent alarms (intradialytic infusion)	2-4 mg tPA	Over 1 h	Via infusion pump—delivered in the dialysis circuit with catheter lumens reversed for 30 min, then with normal positions for next 30 min
Poor functioning catheter post dialysis (lock, post hemodialysis dwell, overnight dwell)	1-2 mg tPA per lumen	Until next dialysis	tPA instilled as push; allowed to dwell in catheter lumen for 48-72 h, until the next hemodialysis session

Note. tPA = tissue plasminogen activator.