Anticoagulant drug use is one of the methods employed to prolong filter life during renal replacement therapy in the critically ill patient. In the Mid Trent Critical Care network, a variety of anticoagulant regimens are used with varying efficacy. This is a retrospective survey of anticoagulant regimens, comparing mechanical filter life, blood product use and documented complications in the five largest units using renal replacement therapy in the region, and to evaluate how effective our regimens were compared to standards defined in the medical literature.
HosteEAJSchurgersM. Epidemiology of acute kidney injury: How big is the problem?Crit Care Med2008;36 Suppl:S146–S151.
2.
UchinoSBellomoRMorimatsuH. Continuous renal replacement therapy: a worldwide practice survey. The Beginning and Ending Supportive Therapy for the Kidney (B.E.S.T. Kidney) Investigators. Intensive Care Med2007;33: 1563–70.
3.
WrightSEBodenhamAShortAIKTurneyJH. The provision and practice of renal replacement therapy on adult intensive care units in the United Kingdom. Anaesthesia2003;58: 1063–69.
4.
MonchiMBerghmansDLedouxD. Citrate vs. heparin for anticoagulation in continuous veno-venous hemofiltration: a prospective randomized study. Intensive Care Med2007;33: 1563–70.
5.
KutsogiannisDJGibneyRT NoelStolleryDGaoJ. Regional citrate versus systemic heparin anticoagulation for continuous renal replacement in critically ill patients. Kidney International2005;67: 2361–67.
6.
ReevesJHCummingsARGallagherL. A controlled trial of low molecular weight heparin (dalteparin) versus unfractionared heparin as anticoagulant during continuous veno-venous hemodialysis with filtration. Crit Care Med1999;27: 2224–28.
7.
JoannidisMMKountchevJRauchenzaunerM. Enoxaparin vs unfractionated heparin for anticoagulation during continuous veno-venous hemofiltration: a randomized controlled crossover study. Intensive Care Med2007;33: 1571–79.
8.
SchwabSJOnoratoJJShararLRDennisPA. Hemodialysis without anticoagulation. Am J Med1987;83: 405–10.
9.
SandersPWTaylorHCurtisJJ. Hemodialysis without anticoagulation. Am J Kidney Dis1985;1: 32–35.
10.
TanHKBaldwinIBellomoR. Continuous veno-venous haemofiltration without anticoagulation in high risk patients. Intensive Care Med2000;26: 1652–57.
11.
BellomoRTeedeHBoyceN. Anticoagulant regimens in acute continuous hemodiafiltration: a comparative study. Intensive Care Med1993;19: 329–32.
12.
UchinoSBaldwinIMorimatsuHBellomoR. Continuous veno-venous hemofiltration without anticoagulation. ASAIO J2004;50: 76–80.
13.
HebertPCWellsGBlajchmanMA. A multicentre randomized controlled trial of transfusion requirements in critical care. N Engl J Med1999;340: 409–17.
14.
SellengKWarkentinTEGreinacherA. Heparin-induced thrombocytopenia in intensive care patients?Crit Care Med2007; 35: 1165–76.
15.
ArepallyGMOrtelTL. Heparin-induced thrombocytopenia. N Engl J Med2006;355: 809–17.
16.
Kozek-LangeneckerSAFelfernigMWerbaA. Anticoagulation with prostacyclin and heparin during continuous veno-venous hemofiltration. Crit Care Med1994;22: 1774–81.
17.
PonikvarRKandusAButurovicJKvedarR. Use of prostacyclin as the only anticoagulant during CVVHF. Contrib Nephrology1991;93: 218–20.
