• N Fealy, I Baldwin, M Johnstone, M Egi, and R Bellomo.
• Department of Intensive Care, Austin Hospital, Melbourne - Australia.
• Int J Artif Organs. 2007 Apr 1;30(4):301-7.

ObjectiveTo evaluate the efficacy and safety of a regional heparinization and a regional citrate method of anticoagulation in CVVH.DesignRandomized controlled cross-over study.SubjectsTen critically ill patients with acute renal failure.SettingICU of tertiary hospital.InterventionCVVH was performed with pre-filter fluid replacement at 2000 ml/h and a blood flow rate of 150 ml/min. Regional heparinization was by the administration of heparin pre-filter at 1500 IU/h and protamine post-filter at 15 mg/h. Regional citrate anticoagulation was by means of a citrate-based replacement fluid (14 mmol/L) administered pre-dilution.ResultsWe studied nine males and one female. The mean age and APACHE II score were 70.5 and 17 respectively. Median circuit life was 13 hours (IQR 9.28) for the regional heparinization method compared to 17 hours (IQR 12,19.5) for the regional citrate method (p=0.77). There were no episodes of bleeding in either group.ConclusionRegional heparinization and regional citrate anticoagulation achieve similar circuit life in critically ill patients receiving CVVH.

33 keywords...

hide…