A cross‐over comparison of the anti‐clotting effects of three low molecular weight heparins and glycosaminoglycuronan.

Stiekema, J. C. J.; Griensven, J. M. T. Van; Dinther, T. G. Van; Cohen, Adam F.

doi:10.1111/j.1365-2125.1993.tb05891.x

Cited by 23 publications

(8 citation statements)

References 15 publications

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“…The LMWHs have a terminal half-life much greater than unfractionated heparin, with enoxaparin having the longest at 27.7 h [20]. The LMWHs have a terminal half-life much greater than unfractionated heparin, with enoxaparin having the longest at 27.7 h [20].…”

Section: Low Molecular Weight Heparinsmentioning

confidence: 99%

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Anticoagulation Options for Pediatric Hemodialysis

Davenport

2003

Hemodialysis International

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Blood coagulation in the extracorporeal hemodialysis circuit is one of the manifestations of bio-incompatibility that is related to the activation of monocytes, platelets, and the coagulation cascades. Compared to adults, in pediatric patients, the surface area of the extracorporeal circuit is increased relative to blood volume. This is due to the patient's smaller blood volume and the combination of the higher relative surface area of the dialyzer, smaller lumen lines, and small-bore vascular catheters, potentially increasing contact activation of coagulation proteins, platelets, and inflammatory cells. Although unfractionated heparin remains the most commonly used anticoagulant, low molecular weight heparin offers the advantages of a single bolus, less fibrin and platelet deposition in the dialyzer, and perhaps more importantly, less osteoporosis, hyperkalemia, and abnormal lipoprotein profile. Although regional anticoagulants are available, these are often prohibitively expensive or require increased complexity of the dialysis procedure (e.g., citrate), but have the advantage of reducing the risk of bleeding when compared to heparin. Thrombin inhibitors are now available, and with the advent of argatroban, which is metabolized in the liver, have become the anticoagulants of choice for the few patients who develop heparin-induced thrombocytopenia type II.

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Section: Low Molecular Weight Heparinsmentioning

confidence: 99%

“…The currently available LMWHs, dalteparin, enoxaparin, nadroparin, reviparin, and tinzaparin differ in size, half-life, and biological activity. The LMWHs have a terminal half-life much greater than unfractionated heparin, with enoxaparin having the longest at 27.7 h [20].…”

Section: Low Molecular Weight Heparinsmentioning

confidence: 99%

Anticoagulation Options for Pediatric Hemodialysis

Davenport

2003

Hemodialysis International

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“…Half-life activity against both factors Xa and IIa is greater for danaparoid compared to the LMWHs; yet following bolus administration, the initial effect on anti-IIa activity is least with danaparoid (46). The longer half-life of plasma anti-Xa activity, 18-25 hours, could cause problems of overanticoagulation during CRRT when too great an infusion dose is used.…”

Section: Synthetic Heparins/heparinoidsmentioning

confidence: 99%

Anticoagulation in Patients With Acute Renal Failure Treated With Continuous Renal Replacement Therapies

Davenport¹

1998

Home Hemodialysis International

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A lthough continuous renal replacement therapy (CRRT) provides greater cardiovascular and cerebrovascular stability compared to standard intermittent hemodialysis and/ or hemofiltration, to provide adequate solute removal, the CRRT circuit must function continuously. Patients with acute renal failure are usually prothrombotic, with activation of the contact coagulation cascade and reduction in the natural anticoagulants. Thus clotting within the extracorporeal circuit can be problematic. Coagulation requires activation of the coagulation protein enzymes, calcium, platelets, and contact with phospholipid cell surface or, in the case of the CRRT circuit, plastic tubing and the dialyzer membrane. This results in a platelet plug stabilized by cross-linking strands of fibrin. Anticoagulation regimes are either directed at trying to prevent contact activation of clotting factors and platelets or the administration of agents designed to prevent coagulation by blocking the coagulation cascade or platelet activation.

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“…The currently available LMWHs, dalteparin, enoxaparin, and nadroparin, differ in size, half‐life, and biological activity (46). The terminal half‐life is much greater for the LMWHs than unfractionated heparin, with enoxaparin (Clexane) having the longest at 27.7 hours (46). Half‐lives are increased in renal failure, because in the healthy subject LMWHs are degraded in the proximal tubules.…”

Section: Anticoagulation For Crrtmentioning

confidence: 99%

“…Half‐life activity against both factors Xa and IIa is greater for danaparoid compared to the LMWHs; yet following bolus administration, the initial effect on anti‐IIa activity is least with danaparoid (46). The longer half‐life of plasma anti‐Xa activity, 18–25 hours, could cause problems of overanti‐coagulation during CRRT when too great an infusion dose is used.…”

Section: Anticoagulation For Crrtmentioning

confidence: 99%

Anticoagulation in Patients With Acute Renal Failure Treated With Continuous Renal Replacement Therapies

Davenport

1998

Home Hemodialysis International

View full text Add to dashboard Cite

Although continuous renal replacement therapy (CRRT) provides greater cardiovascular and cerebrovascular stability compared to standard intermittent hemodialysis and/ or hemofiltration, to provide adequate solute removal, the CRRT circuit must function continuously. Patients with acute renal failure are usually prothrombotic, with activation of the contact coagulation cascade and reduction in the natural anticoagulants. Thus clotting within the extracorporeal circuit can be problematic. Coagulation requires activation of the coagulation protein enzymes, calcium, platelets, and contact with phospholipid cell surface or, in the case of the CRRT circuit, plastic tubing and the dialyzer membrane. This results in a platelet plug stabilized by cross-linking strands of fibrin. Anticoagulation regimes are either directed at trying to prevent contact activation of clotting factors and platelets or the administration of agents designed to prevent coagulation by blocking the coagulation cascade or platelet activation.

show abstract

A cross‐over comparison of the anti‐clotting effects of three low molecular weight heparins and glycosaminoglycuronan.

Cited by 23 publications

References 15 publications

Anticoagulation Options for Pediatric Hemodialysis

Anticoagulation Options for Pediatric Hemodialysis

Anticoagulation in Patients With Acute Renal Failure Treated With Continuous Renal Replacement Therapies

Anticoagulation in Patients With Acute Renal Failure Treated With Continuous Renal Replacement Therapies

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