Related Experiment Video
Updated: Aug 19, 2026

In Vitro Thrombosis Test for Ventricular Assist Devices
Published on: March 21, 2025
Filter run time in CVVH: pre- versus post-dilution and nadroparin versus regional heparin-protamine anticoagulation
P H J van der Voort1, R T Gerritsen, M A Kuiper
1Department of Intensive Care, Medical Centre Leeuwarden, NR-8901 BR Leeuwarden, The Netherlands. phjvdvoort@chello.nl
Background/Aims:
To study the effect of different modes of continuous veno-venous haemofiltration (CVVH) on filter run time (FRT).
Methods:
We studied, in two consecutive prospective, randomised and crossover studies, 16 and 15 patients with acute renal failure during critical illness. Study A compared pre- versus post-dilution, and study B compared regional anticoagulation with heparin (pre-filter) and protamine (post-filter) (HP) versus nadroparin (NP) pre-filter. All CVVH sessions were standardised. Analyses were by Wilcoxon rank sum tests.
Results:
Study A: During pre-dilution the median FRT was 45.7 vs. 16.1 h in post-dilution CVVH (p = 0.005). The median creatinine clearance during pre-dilution was 33 vs. 45 ml/min in post-dilution (p = 0.001). Study B: During NP, median FRT was 39.5 vs. 12.3 h during HP CVVH (p = 0.045).
Conclusions:
Pre-dilution CVVH results in the greatest FRT but a lower plasma creatinine clearance compared to post-dilution. Regional anticoagulation with heparin-protamine resulted in a significantly shorter FRT compared to systemic NP anticoagulation.
Related Concept Videos
Anticoagulant Drugs: Low-Molecular-Weight Heparins
Venous Thrombosis III: Interprofessional Care
Cardiac Catheterization IV: Nursing Management
