The in vitro Bleeding Time While Using a Stable Prostacyclin Analogue during Hemodialysis

Abstract

A serious disadvantage of preventing clot formation by using prostacyclin (PGI₂) to inhibit thrombocyte function during dialysis is that there exists no rapidly measurable monitoring parameter. The “in vitro bleeding time” fin vitro BT) is a new method for measuring primary hemostasis in vitro. Five chronic dialysis patients each underwent two dialyses: 1) with conventional full heparinization, and 2) with the stable PGI₂ analogue CG 4203 and additional “low-dose” heparin. The predialytic in vitro BT is longer than normal values and values 1 h after the end of dialysis. While heparin has no significant effect on the in vitro BT, CG 4203 prolongs it concentration-dependently. Infusing CG 4203 at a rate of 25 ng/kg/min, the in vitro BT is extended beyond the measurable range of 800 μl during the first approx. 150 min of dialysis. During the next approx. 90 min it steadily decreases.