Comparative study of anticoagulation versus saline flushes in continuous renal replacement therapy
Joint Authors
Soni, S. S.
Adikey, Gopal Kishan
Raman, Anuradha S.
Nagarik, Amit P.
Source
Saudi Journal of Kidney Diseases and Transplantation
Issue
Vol. 21, Issue 3 (30 Jun. 2010), pp.478-483, 6 p.
Publisher
Saudi Center for Organ Transplantation
Publication Date
2010-06-30
Country of Publication
Saudi Arabia
No. of Pages
6
Main Subjects
Topics
- Patients
- Comparative analysis
- Kidneys
- Diseases
- Therapeutics
- Anticoagulants
- Blood
- Blood coagulation factors
- Kidney failure
Abstract EN
Systemic heparinization during continuous renal replacement therapy (CRRT) is associated with disadvantage of risk of bleeding.
This study analyses the efficacy of frequent saline flushes compared with heparin anticoagulation to maintain filter life.
From January 2004 to November 2007, 65 critically ill patients with acute renal failure underwent CRRT.
Continuous venovenous hemodialfiltration (CVVHDF) was performed using Diapact Braun CRRT machine.
1.7% P.D.
fluid was used as dialysate.
0.9% NS with addition of 10% Ca Gluconate, Magnesium Sulphate, Soda bicarbonate and Potassium Chloride added sequentially in separate units were used for replacement, carefully monitoring their levels.
Anticoagulation of extracorporeal circuit was achieved with unfractionated heparin (250-500 units alternate hour) in 35 patients targeting aPTT of 45-55 seconds.
No anticoagulation was used in 30 patients with baseline APTT > 55 seconds and extracorporeal circuit was maintained with saline flushes at 30 min interval.
65 patients including 42 males.
Co-morbidities were comparable in both groups.
HMARF was significantly more common in heparin group while Sepsis was comparable in both the groups.
CRRT parameters were similar in both groups.
Average filter life in heparin group was 26 ± 6.4 hours while it was 24.5 ± 6.36 hours in heparin free group ( P=NS).
Patients receiving heparin had 16 bleeding episodes (0.45/patient) while only four bleeding episodes occurred in heparin free group (0.13/patient, P< 0.05).
Mortality was 71% in heparin group and 67% in heparin free group.
Frequent saline flushes is an effective mode of maintainance of extracorporeal circuit in CRRT when aPTT is already on the higher side, with significantly decreased bleeding episodes.
American Psychological Association (APA)
Nagarik, Amit P.& Soni, S. S.& Adikey, Gopal Kishan& Raman, Anuradha S.. 2010. Comparative study of anticoagulation versus saline flushes in continuous renal replacement therapy. Saudi Journal of Kidney Diseases and Transplantation،Vol. 21, no. 3, pp.478-483.
https://search.emarefa.net/detail/BIM-63600
Modern Language Association (MLA)
Nagarik, Amit P.…[et al.]. Comparative study of anticoagulation versus saline flushes in continuous renal replacement therapy. Saudi Journal of Kidney Diseases and Transplantation Vol. 21, no. 3 (Jun. 2010), pp.478-483.
https://search.emarefa.net/detail/BIM-63600
American Medical Association (AMA)
Nagarik, Amit P.& Soni, S. S.& Adikey, Gopal Kishan& Raman, Anuradha S.. Comparative study of anticoagulation versus saline flushes in continuous renal replacement therapy. Saudi Journal of Kidney Diseases and Transplantation. 2010. Vol. 21, no. 3, pp.478-483.
https://search.emarefa.net/detail/BIM-63600
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references : p. 482-483
Record ID
BIM-63600