Coagulation, Fibrinolysis and Inhibitors in Failing Filters during Continuous Venovenous Hemofiltration in Critically Ill Patients with Acute Kidney Injury: Effect of Anticoagulation Modalities

Autor:	S. Azam Nurmohamed, Robert H.J. Beelen, Nanne J. Paauw, Pieter M. ter Wee, Louise Schilder, A. B. Johan Groeneveld, Armand R. J. Girbes, Albertus Beishuizen
Přispěvatelé:	Intensive Care, Nephrology, Intensive care medicine, Molecular cell biology and Immunology, ICaR - Circulation and metabolism
Rok vydání:	2015
Předmět:	Adult Male medicine.medical_specialty Time Factors Critical Illness medicine.medical_treatment Citric Acid Young Adult Sepsis Fibrinolysis medicine Blood Coagulation Factor Inhibitors Humans Platelet activation Intensive care medicine Blood Coagulation Aged Aged 80 and over Modalities Heparin Critically ill business.industry Micropore Filters Acute kidney injury Anticoagulants Hematology General Medicine Acute Kidney Injury Middle Aged medicine.disease Continuous venovenous hemofiltration Nephrology Female Hemofiltration Coagulation fibrinolysis business
Zdroj:	Schilder, L, Nurmohamed, S A, ter Wee, P M, Paauw, N J, Girbes, A R J, Beishuizen, A, Beelen, R H J & Groeneveld, A B J 2015, ' Coagulation, Fibrinolysis and Inhibitors in Failing Filters during Continuous Venovenous Hemofiltration in Critically Ill Patients with Acute Kidney Injury: Effect of Anticoagulation Modalities ', Blood Purification, vol. 39, no. 4, pp. 297-305 . https://doi.org/10.1159/000380904 Blood Purification, 39(4), 297-305. Karger Blood Purification, 39(4), 297-305. S. Karger AG
ISSN:	1421-9735 0253-5068
DOI:	10.1159/000380904
Popis:	Introduction: The mechanisms of early filter failure and clotting with different anticoagulation modalities during continuous venovenous hemofiltration (CVVH) are largely unknown. Methods: Citrate, heparin and no anticoagulation were compared. Blood was drawn pre- and post filter up to 720 min. Concentrations of the thrombin-antithrombin (TAT), activated protein C-protein C inhibitor (APC-PCI), and type I plasminogen activator inhibitor (PAI-1) were determined. Results: In case of early filter failure (Conclusion: Coagulation activation in plasma and inhibition of anticoagulation in plasma and filter may partly determine early CVVH filter failure due to clotting, particularly when heparin is used. Regional anticoagulation by citrate circumvents the inhibition of anticoagulation and fibrinolysis by platelet activation following heparin.
Databáze:	OpenAIRE
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