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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
Summary
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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.

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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.