PMID: 15354980Sep 10, 2004Paper

Intermittent hirudin versus continuous heparin for anticoagulation in continuous renal replacement therapy

Renal Failure
Ortrud Vargas HeinClaudia Spies

Abstract

Besides possible bleeding complications a further problem in anticoagulation during continuous renal replacement therapy (CRRT) is the development of heparin-induced thrombocytopenia type II (HIT II) where further anticoagulation with heparin is contraindicated. The application of continuous hirudin as alternative for heparin caused bleeding complications by comparable filter efficacy. Aim of this prospective-controlled pilot study was to compare the efficacy and safety of intermittent hirudin and continuous heparin for anticoagulation during CRRT in critically ill patients. 26 patients receiving CRRT were randomly allocated to two groups: Heparin group (14 patients): continuous administration of 250 IU/h heparin, dose was adjusted in 125 IU/h steps with a targeted activated clotting time (ACT) of 180-210 s. Hirudin group (12 patients): initial bolus application of 2-2-5 microg/kg hirudin, dose was adjusted in 2 microg/kg bolus steps with a targeted ecarin clotting time (ECT) >80 s. Observation time was 96 hours. Measured filter run time was virtually longer for heparin. No bleeding complications were observed in the hirudin group, two bleeding complications in the heparin group. Intermittent hirudin can be used safely for anti...Continue Reading

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Citations

Aug 9, 2006·Seminars in Dialysis·Jamshid Amanzadeh, Robert F Reilly
Mar 13, 2020·The Cochrane Database of Systematic Reviews·Hiraku TsujimotoYuki Kataoka
Feb 3, 2006·Intensive Care Medicine·H M Oudemans-van StraatenM R C Schetz
Jul 9, 2009·The Annals of Pharmacotherapy·Scott W MuellerTyree H Kiser
May 12, 2009·Seminars in Dialysis·Ashita J Tolwani, Keith M Wille
Dec 15, 2020·The Cochrane Database of Systematic Reviews·Hiraku TsujimotoYuki Kataoka
Apr 12, 2007·Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses·Hugh Davies, Gavin Leslie

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