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Optimization of heparin anticoagulation during membrane plasma separation
G M Frascà1, A Buscaroli, L C Borgnino
1Institute of Nephrology, St. Orsola Univ. Hospital, Bologna-Italy.
The International Journal of Artificial Organs
|July 1, 1988
Summary
This study defines optimal heparin anticoagulation during membrane plasma exchange. Findings provide guidelines for precise heparin dosing based on patient hematocrit and plasma flow, ensuring safe and effective treatment.
Area of Science:
- Nephrology
- Pharmacokinetics
Background:
- Membrane plasma exchange (PEX) requires careful anticoagulation.
- Heparin is commonly used, but its behavior during PEX is not fully understood.
Purpose of the Study:
- To define heparin kinetics during PEX.
- To establish appropriate anticoagulation levels and dosing guidelines.
Main Methods:
- Analysis of 75 PEX procedures in 18 patients.
- Measurement of heparin concentration using a specific assay.
- Correlation of heparin levels with Activated Partial Thromboplastin Time (aPTT).
Main Results:
- Heparin distribution volume was 10-25% higher than expected.
- Heparin was filtered with a sieving coefficient of 1.
- Optimal heparin concentration range is 0.2-0.5 IU/mL.
- Heparin levels strongly correlated with aPTT (p < 0.001).
- Individual heparin requirements correlated with patient hematocrit and plasma flow (p < 0.001).
Conclusions:
- Heparin pharmacokinetics during PEX differ from standard expectations.
- Guidelines for determining patient-specific heparin dosage are provided.
- This research aids in optimizing anticoagulation during plasma exchange procedures.