[Tracheobronchial injuries and fistulas]

Area of Science:

• Nephrology
• Hematology
• Biomaterials Science

Context:

• Blood contact with artificial surfaces during continuous haemofiltration (CHF) triggers pathophysiological processes.
• Platelets play a key role in the development of extracorporeal thrombosis.
• Effective renal replacement therapy necessitates adequate anticoagulation to prevent circuit clotting.

Purpose:

• To review pathophysiological mechanisms of thrombosis during CHF.
• To assess antithrombotic strategies for managing coagulation activation and platelet-surface interactions.
• To evaluate coagulation monitoring methods in CHF.

Summary:

• Antithrombotic regimens are reviewed, including combined therapies with prostaglandins and heparin for bleeding patients, proving more effective than heparin alone.
• Heparinoids and hirudin are recommended for patients with heparin-induced thrombocytopenia type II.
• Regional citrate anticoagulation may benefit patients at risk for thromboembolism; CHF without anticoagulation is not advised.

Impact:

• Provides evidence-based guidance on optimizing anticoagulation strategies in continuous haemofiltration.
• Aims to reduce bleeding complications, morbidity, and extracorporeal thrombosis during renal replacement therapy.
• Highlights the importance of tailored antithrombotic approaches based on patient risk profiles.