Iloprost for Additional Anticoagulation in Continuous Renal Replacement Therapy—A Pilot Study

Abstract

Purpose. The aim of this pilot study was to compare the effect of heparin anticoagulation with and without iloprost administration during continuous renal replacement therapy (CRRT) in critically ill patients. Material and methods. In a prospective, randomized, controlled pilot study at an intensive care unit at a university hospital, 20 patients requiring CRRT were investigated. Patients were allocated into two groups: group 1, the heparin group; and group 2, the heparin plus 1 ng/kg/min iloprost. In both groups, activated partial thromboplastin time (aPTT) was adjusted to 40-50 sec. Observation time was a maximum of 7 days. Results. Median filter run time was significantly prolonged by iloprost administration to a median of 14 h (13-26 h) compared to 10 h (4-12 h) in the heparin group (p = 0.004). A decrease in platelet count was attenuated by iloprost administration (p = 0.012). There were no bleeding complications in either group. Hemofiltration efficiency did not differ significantly between the groups. Conclusion. Additional administration of iloprost prolonged the filter run time of continuous veno-venous hemofiltration (CVVH) in this setting and attenuated the fall in platelet count during CRRT.

Impact of stable PGI2analog iloprost on early graft viability after liver transplantation: a pilot study

“…However, the observed rates of re‐laparotomies because of bleeding or intra‐abdominal hematoma were comparable in both our groups. Therefore, an increased risk of bleeding complications under iloprost treatment cannot be assumed (50, 51).…”

Contrast-induced acute kidney injury and renal support for acute kidney injury: a KDIGO summary (Part 2)

“…A few small trials showed improved filter survival during CRRT when adding prostaglandins to heparin compared with heparin alone [95-97]. However, prostaglandins appear to have a limited efficacy when used alone, induce systemic hypotension [98,99], and are expensive.…”

Section 5: Dialysis Interventions for Treatment of AKI

“…594, 595, 596 A few small trials showed improved filter survival during CRRT when adding prostaglandins to heparin compared to heparin alone. 622, 623, 624 However, prostaglandins appear to have a limited efficacy when used alone, induce systemic hypotension, 625, 626 and are expensive. Their use during CRRT can therefore not be recommended.…”