Anest. intenziv. Med. 2008;19(3):154-158
Anticoagulation for extracorporeal renal replacement therapy in the critically illIntesive Care Medicine - Review Article
- JIP, I. interní klinika, Fakultní nemocnice a LF UK, Plzeň
Anticoagulation of the extracorporeal circuit is usually required to prevent its clotting during renal replacement therapy. However, anticoagulants may cause significant bleeding and critically ill patients are at increased risk of it. This article analyses the implementation, efficacy and safety of anticoagulation strategies in renal replacement therapy in the critical care setting and gives a summary of the causes of extracorporeal circuit blood clotting.
Keywords: anticoagulation; renal replacement therapy; critically ill
Received: February 19, 2008; Accepted: March 31, 2008; Published: June 1, 2008 Show citation
References
- Cutts, M. W. et al. Transfusion requirements during continuous veno-venous haemofiltration: the importance of filter life. Intensive Care Med., 2000, 26, 11, p. 1694-1697.
Go to original source...
Go to PubMed...
- Davenport, A. The coagulation system in the critically ill patient with acute renal failure and the effect of an extracorporeal circuit. Am. J. Kidney Dis., 1997, 30, 5, Suppl 4, p. S20-S27.
Go to original source...
Go to PubMed...
- Opatrný, K. Jr. Biokompatibilita dialyzačních mebrán. Plzeň: Euroverlag Plzeň, s. r. o., III/2000.
- Cardigan, R. A. et al. Activation of the tissue factor pathway occurs during continuous venovenous hemofiltration. Kidney Int., 1999, 55, 4, p. 1568-1574.
Go to original source...
Go to PubMed...
- Levi, M., Opal, S. M. Coagulation abnormalities in critically ill patients. Crit. Care, 2006, 10, 4, p. 222.
Go to original source...
Go to PubMed...
- Jean, G. et al. Central venous catheters for haemodialysis: looking for optimal blood flow. Nephrol. Dial. Transplant., 1997, 12, 8, p. 1689-1691.
Go to original source...
Go to PubMed...
- Baldwin, I. et al. Blood flow reductions during continuous renal replacement therapy and circuit life. Intensive Care Med., 2004, 30, 11, p. 2074-2079.
Go to original source...
Go to PubMed...
- Mehta, R. Anticoagulation for continuous renal replacement therapies. In Ronco, C., Bellomo, R. Critical Care Nephrology. Dordrecht: Kluwer Academic Publisher, 1998, p. 1199-1211.
Go to original source...
- Ronco, C. et al. Effects of different doses in continuous veno-venous haemofiltration on outcomes of acute renal failure: a prospective randomised trial. Lancet, 2000, 1, 356, 9223, p. 26-30.
Go to original source...
Go to PubMed...
- Hirsh, J. et al. Heparin and low-molecular-weight heparin: mechanisms of action, pharmacokinetics, dosing, monitoring, efficacy, and safety. Chest, 2001, 119, 1 Suppl, p. 64S-94S.
Go to original source...
Go to PubMed...
- Oudemans-van Straaten, H. M. et al. Anticoagulation strategies in continuous renal replacement therapy: can the choice be evidence based? Intensive Care Med., 2006, 32, 2, p. 188-202.
Go to original source...
Go to PubMed...
- Farooq, V. et al. Serious adverse incidents with the usage of low molecular weight heparins in patients with chronic kidney disease. Am. J. Kidney Dis., 2004, 43, 3, p. 531-537.
Go to original source...
Go to PubMed...
- Lindhoff-Last, E. et al. Use of a low-molecular-weight heparinoid (danaparoid sodium) for continuous renal replacement therapy in intensive care patients. Clin. Appl. Thromb. Hemost., 2001, 7, 4, p. 300-304.
Go to original source...
Go to PubMed...
- Vargas Hein, O. et al. Hirudin versus heparin for anticoagulation in continuous renal replacement therapy. Intensive Care Med., 2001, 27, 4, p. 673-679.
Go to original source...
Go to PubMed...
- Kozek-Langenecker, S. A. et al. Effect of prostacyclin on platelets, polymorphonuclear cells, and heterotypic cell aggregation during hemofiltration. Crit. Care Med., 2003, 31, 3, p. 864-868.
Go to original source...
Go to PubMed...
- Kozek-Langenecker, S. A. et al. Anticoagulation with prostaglandin E1 and unfractionated heparin during continuous venovenous hemofiltration. Crit. Care Med., 1998, 26, 7, p. 1208-1212.
Go to original source...
Go to PubMed...
- Dellinger, R. P. et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med., 2008, 36, 1, p. 296-327.
Go to original source...
Go to PubMed...
- Rossmann, P. et al. Protamine-heparin aggregates. Their fine structure, histochemistry, and renal deposition. Virchows Arch., 1982, 40, 1, p. 81-98.
Go to original source...
- Mehta, R. L. et al. Regional citrate anticoagulation for continuous arteriovenous hemodialysis in critically ill patients. Kidney Int., 1990, 38, 5, p. 976-981.
Go to original source...
Go to PubMed...
- Gabutti, L. et al. Citrate anticoagulation in continuous venovenous hemodiafiltration: a metabolic challenge. Intensive Care Med., 2002, 28, 10, p. 1419-1425.
Go to original source...
Go to PubMed...
- Tan, H. K. et al. Continuous veno-venous hemofiltration without anticoagulation in high-risk patients. Intensive Care Med., 2000, 26, 11, p. 1652-1657.
Go to original source...
Go to PubMed...
- van der Voort, P. H. et al. Filter run time in CVVH: pre- versus post-dilution and nadroparin versus regional heparin-protamine anticoagulation. Blood Purif., 2005, 23, 3, p. 175-180.
Go to original source...
Go to PubMed...
- Gupta, M. et al. Regional citrate anticoagulation for continuous venovenous hemodiafiltration using calcium-containing dialysate. Am. J. Kidney Dis., 2004, 43, 1, p. 67-73.
Go to original source...
Go to PubMed...
- Kramer, L. et al. Citrate pharmacokinetics and metabolism in cirrhotic and noncirrhotic critically ill patients. Crit Care Med., 2003, 31, 10, p. 2450-2455.
Go to original source...
Go to PubMed...
- Meier-Kriesche, H. U. et al. Increased total to ionized calcium ratio during continuous venovenous hemodialysis with regional citrate anticoagulation. Crit Care Med., 2001, 29, 4, p. 748-752.
Go to original source...
Go to PubMed...
- Opatrny, K. Jr et al. A clinical study to assess the effect of heparin in dialyzer rinsing solutions. Int. J. Artif. Organs., 1997, 20, 2, p. 112-118.
Go to original source...
- Opatrny, K. Jr et al. The effect of heparin rinse on the biocompatibility of continuous veno-venous hemodiafiltration. Int. J. Artif. Organs., 2002, 25, 6, p. 520-528.
Go to original source...
Go to PubMed...