Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Feb 2002
Comparative StudyRegional citrate anticoagulation using a citrate-based substitution solution for continuous venovenous hemofiltration in cardiac surgery patients.
To evaluate the feasibility, efficacy, safety and side effects of routinely performed continuous venovenous hemofiltration (CVVH) with regional citrate anticoagulation using a citrate-containing substitution solution as compared with conventional systemic low-dose unfractionated heparin-anticoagulation in postoperative cardiac surgery patients. ⋯ We conclude that citrate-based regional anticoagulation is effective, safe and easy to use in CVVH following cardiac surgery and might become the first choice for anticoagulation in patients in whom the application of systemic heparin is contraindicated.
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Wien. Klin. Wochenschr. · Feb 2002
Randomized Controlled Trial Comparative Study Clinical TrialAnticoagulation with prostaglandins and unfractionated heparin during continuous venovenous haemofiltration: a randomized controlled trial.
The objective of this prospective, randomized, controlled clinical study was to compare efficacy, safety, and costs of fixed-dose prostaglandins with adjusted-dose unfractionated heparin as anticoagulants for continuous venovenous haemofiltration. ⋯ Fixed-dose prostaglandins I2 and E1 reduced the incidence of haemofilter failure and bleeding when compared with adjusted-dose unfractionated heparin. There was no significant difference between the two prostaglandin groups. The increase in daily costs for haemofiltration treatment under prostaglandins is not clinically relevant.
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Wien. Klin. Wochenschr. · Feb 2002
Comparative StudySafety of hypertonic hyperoncotic solutions--a survey from Austria.
Hypertonic hyperoncotic solutions (HHS), composed of 7.2 to 7.5% sodium chloride and 6 to 10% dextran or hydroxyethyl starch, are able to restore the disturbed macro- and microcirculation in hypovolemic states within a short period of time. Even small amounts of HHS induce a relevant fluid shift from the extravasal into the intravasal space, and the use of HHS has thus been recommended in acute hypovolemia and hypovolemic shock (principle of "small-volume resuscitation"). Recently, attention has also focused on the treatment of elevated intracranial pressure using HHS. Austria is the only European country where market authorization of HHS was already obtained several years ago and where HHS have been widely used in clinical routine for a comparatively long time. This offers the unique possibility of evaluating, for the first time, the safety profile of HHS solutions. In this study, we analyzed the reported adverse drug reactions of HHS in a large number of applications. ⋯ Austrian experience with the use of a large number of HHS in clinical routine during nearly a decade indicates that the prescribed application of a combination of hydroxyethyl starch and hypertonic sodium chloride has a low potential for complications.