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The in vitro bleeding time while using a stable prostacyclin analogue during hemodialysis
1Department of Internal Medicine II, University Clinic, RWTH Aachen, FRG.
A serious disadvantage of preventing clot formation by using prostacyclin (PGI2) to inhibit thrombocyte function during dialysis is that there exists no rapidly measurable monitoring parameter. The "in vitro bleeding time" (in vitro BT) is a new method for measuring primary hemostasis in vitro. Five chronic dialysis patients each underwent two dialyses: 1) with conventional full heparinization, and 2) with the stable PGI2 analogue CG 4203 and additional "low-dose" heparin. The predialytic in vitro BT is longer than normal values and values 1 h after the end of dialysis. While heparin has no significant effect on the in vitro BT, CG 4203 prolongs it concentration-dependently. Infusing CG 4203 at a rate of 25 ng/kg/min, the in vitro BT is extended beyond the measurable range of 800 microliter during the first approx. 150 min of dialysis. During the next approx. 90 min it steadily decreases.
A serious disadvantage of preventing clot formation by using prostacyclin (PGI2) to inhibit thrombocyte function during dialysis is that there exists no rapidly measurable monitoring parameter. The "in vitro bleeding time" (in vitro BT) is a new method for measuring primary hemostasis in vitro. Five chronic dialysis patients each underwent two dialyses: 1) with conventional full heparinization, and 2) with the stable PGI2 analogue CG 4203 and additional "low-dose" heparin. The predialytic in vitro BT is longer than normal values and values 1 h after the end of dialysis. While heparin has no significant effect on the in vitro BT, CG 4203 prolongs it concentration-dependently. Infusing CG 4203 at a rate of 25 ng/kg/min, the in vitro BT is extended beyond the measurable range of 800 microliter during the first approx. 150 min of dialysis. During the next approx. 90 min it steadily decreases.