Citrate Versus Heparin Anticoagulation in Continuous Venovenous Hemofiltration

Launched by FREE UNIVERSITY MEDICAL CENTER · Sep 13, 2005

Keywords

ClinConnect Summary

Acute renal failure occurs in about 20% of critically ill patients and is associated with increased morbidity and mortality, in spite of modern renal replacement techniques. The latter include continuous venovenous hemofiltration (CVVH) techniques, necessitating anticoagulation of blood entering the extracorporeal circuit to prevent premature clot formation and hemofilter dysfunction. Heparin is commonly used for that purpose, but carries a serious risk of bleeding complications and heparin induced thrombocytopenia. In a subgroup of critically ill patients systemic anticoagulation is absolu...

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Eligibility criteria

• Inclusion Criteria:
• • Patients admitted on the Intensive Care Unit (ICU) requiring continuous venovenous hemofiltration.
• • No high bleeding risk. A high bleeding risk is defined as a platelet count below 40 x 10\^9/L or APTT of more than 60 seconds or a PT-INR of more than 2.0 or a recent major bleeding or significant active bleeding i.e. requirement for more than two units of packed red blood cells as a transfusion within 24 hours of initiation of CVVH.
• Exclusion Criteria:
• • Less than 18 or over 80 years of age.
• • Patients administered heparin or coumarins for other reasons will also be excluded.
• • Patients with a HIT in known history will also be excluded.