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Anticoagulation during continuous renal replacement therapy

R L Mehta1

  • 1Department of Medicine, University of California, San Diego.

ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|October 1, 1994
PubMed

Insights

Anticoagulation is crucial for continuous renal replacement therapy (CRRT) filter function. Selecting the right anticoagulant considers patient factors, access, and membrane type to prevent complications.

Area of Science:

  • Nephrology
  • Critical Care Medicine

Background:

  • Anticoagulation is vital for the function and longevity of filters used in continuous venovenous hemofiltration (CAVH) or CAVHD and is a critical challenge in continuous renal replacement therapy (CRRT).
  • Multiple anticoagulation strategies are available, allowing for selection based on patient-specific characteristics, anticoagulant availability, and institutional expertise.

Purpose of the Study:

  • To review and discuss the factors influencing the choice of anticoagulation in CRRT.
  • To highlight the importance of careful selection and monitoring of anticoagulation to prevent complications.

Main Methods:

  • Review of current anticoagulation options and influencing factors in CRRT.
  • Discussion of patient-specific considerations for anticoagulant selection.

Main Results:

  • Anticoagulant choice depends on access site, pump use, membrane characteristics, ultrafiltration enhancements (e.g., predilution), and patient's clinical status and coagulation profile.
  • Continuous anticoagulation in CRRT requires longer duration and thus more meticulous management than in intermittent hemodialysis.

Conclusions:

  • Careful selection and vigilant monitoring of anticoagulation are essential for successful CRRT and prevention of filter-related complications.
  • Tailoring anticoagulation strategies to individual patient needs and treatment parameters optimizes filter performance and patient safety.

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