Anticoagulation with prostacyclin and heparin during continuous venovenous hemofiltration

Langenecker, Sibylle A.; Felfernig, Michael; Werba, A.; Mueller, Claudia; Chiari, Astrid; Zimpfer, Michael

doi:10.1097/00003246-199422110-00012

Cited by 77 publications

(27 citation statements)

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“…Other papers studied the effect of regional anticoagulation limited to a high‐risk bleeding population 11–13 . In our study, the median filter life obtained in G2 (19 h) is comparable with that obtained by Langenecker et al 1 , who obtained a mean circuit lifetime of 14–17 h using heparin. Similar results have also been reported by Baldwin et al 16 However, the median filter life observed in G1 (68 h) is much longer than that obtained in previous works that used regional anticoagulation 5,10–15 .…”

Section: Discussionsupporting

confidence: 91%

“…This can be explained by both the low PGI2 doses used and by PGI2 partial loss into the extracorporeal circuit. Moreover, the combined use of heparin and PGI2 has been shown to be more effective than either drug alone 1 …”

Section: Discussionmentioning

confidence: 99%

“…A cute renal failure (ARF) is still a common problem in critical care units, and continuous veno‐venous haemofiltration (CVVH) is currently considered as an appropriate option for its treatment in critically ill patients 1 . CVVH needs continuous anti‐haemostasis to maintain circuit patency, as circuit is often faced with repeated blockages due to blood clotting and platelet activation and aggregation.…”

mentioning

confidence: 99%

“…Prostacyclin (PGI2), an inhibitor of platelet aggregation, activation and adhesion, has also been proposed as an alternative to systemic heparin to inhibit filter clotting during CVVH. It has been reported that it prolongs the filter lifespan and improves both the quality and the duration of treatment 1,6 …”

mentioning

confidence: 99%

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Regional anticoagulation and antiaggregation for CVVH in critically ill patients: a prospective, randomized, controlled pilot study

Nucera

Malyan

Becchi

2009

Acta Anaesthesiol Scand

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Regional anticoagulation and antiaggregation for CVVH in critically ill patients: a prospective, randomized, controlled pilot study

Nucera

Malyan

Becchi

2009

Acta Anaesthesiol Scand

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“…Langenecker et al [45] evaluated 46 critically ill adults on continuous veno-venous haemofiltration (CVVH) who had been randomized into 3 groups - group 1: heparin, group 2: prostacyclin, and group 3: heparin and prostacyclin. Filter life, haemostatic and haemodynamic variables were evaluated at various time intervals.…”

Section: Evidence For Use Of Prostacyclin For Crrt In Childrenmentioning

confidence: 99%

Prostacyclin as an Anticoagulant for Continuous Renal Replacement Therapy in Children

Deep

Zoha²,

Kukreja³

2017

Blood Purif

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Effective delivery of continuous renal replacement therapy (CRRT) depends on the longevity of the filter and circuit used in the CRRT machine. Safe and effective anticoagulation is crucial for maintaining the patency of these circuits. In children, heparin and citrate are the commonly used anticoagulants but they are limited by serious side effects and thus calls for meticulous monitoring. In conditions where neither of these can be used, prostacyclin can be an effective alternative. Prostacyclin is a platelet inhibitor that can be safely used as an efficient anticoagulant in CRRT. When combined with heparin, it induces a heparin-sparing effect, which can reduce the dosage and side effects of heparin. Furthermore, there is no need for performing time-consuming monitoring tests. Although prostacyclin seems to be an attractive option, there is scanty evidence about its use as an anticoagulant in CRRT in children. We review the evidence and practicalities, and propose a guideline for the use of prostacyclin as an anticoagulant in children requiring CRRT.

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Pharmacological interventions for preventing clotting of extracorporeal circuits during continuous renal replacement therapy

Tsujimoto

Nakata

et al. 2020

Cochrane Database of Systematic Reviews

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Anticoagulation with prostacyclin and heparin during continuous venovenous hemofiltration

Cited by 77 publications

References 0 publications

Regional anticoagulation and antiaggregation for CVVH in critically ill patients: a prospective, randomized, controlled pilot study

Regional anticoagulation and antiaggregation for CVVH in critically ill patients: a prospective, randomized, controlled pilot study

Prostacyclin as an Anticoagulant for Continuous Renal Replacement Therapy in Children

Pharmacological interventions for preventing clotting of extracorporeal circuits during continuous renal replacement therapy

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