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Related Experiment Videos

Heparin clearance during continuous veno-venous haemofiltration

M Singer1, T McNally, G Screaton

  • 1Bloomsbury Institute of Intensive Care Medicine, Department of Medicine, UCL Medical School, London, UK.

Intensive Care Medicine
|January 1, 1994
PubMed
Summary

Premature clotting in haemofiltration is not due to heparin loss through the filter. Both unfractionated and low molecular weight heparin effectively anticoagulated patients, but low antithrombin III levels may impact filter lifespan.

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Area of Science:

  • Nephrology
  • Critical Care Medicine
  • Pharmacology

Background:

  • Haemofiltration is a vital renal replacement therapy for acute renal failure.
  • Circuit clotting is a common complication, potentially linked to anticoagulant efficacy.
  • Heparin is frequently used for anticoagulation during haemofiltration.

Purpose of the Study:

  • To investigate if heparin removal across the haemofilter membrane contributes to premature circuit clotting.
  • To assess the plasma levels and ultrafiltrate concentrations of unfractionated and low molecular weight heparin.
  • To evaluate the role of antithrombin III levels in filter performance.

Main Methods:

  • A randomized study comparing unfractionated heparin (UFH) and low molecular weight heparin (LMWH) in haemofiltration circuits.

Related Experiment Videos

  • Blood samples were analyzed for heparin (anti-Factor Xa activity), antithrombin III, and hematocrit.
  • Ultrafiltrate was collected to measure anti-Xa activity.

    • Main Results:

    • Plasma heparin levels for both UFH and LMWH were therapeutically adequate in most patients.
    • No significant heparin anti-Xa activity was detected in the ultrafiltrate.
    • Subnormal antithrombin III levels were observed in a majority of critically ill patients.

    Conclusions:

    • Heparin does not appear to be removed by the haemofilter membrane in significant amounts.
    • Adequate anticoagulation was achieved with both UFH and LMWH.
    • Low antithrombin III levels may be a critical factor influencing haemofilter circuit longevity.