Intensive care medicine
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Intensive care medicine · Jan 1995
ReviewMaintaining blood flow in the extracorporeal circuit: haemostasis and anticoagulation.
To review the methods and developments in maintaining extracorporeal circuits in critically ill patients. ⋯ Heparin is the mainstay of anticoagulation for the extracorporeal circuit although the complex abnormalities of the coagulation system in critically ill patients are associated with a considerable risk of bleeding. Alternative therapeutic agents and physical strategies (prostacyclin, low molecular weight heparin, sodium citrate, regional anticoagulation, heparin bonding and attention to circuit design) may reduce the risk of bleeding but expense and difficulty in monitoring are disadvantages.