Use of Prostacyclin as the Only Anticoagulant during Continuous Venovenous Hemofiltration

Ponikvar, Rafael; Kandus, A.; Buturović, J; Kveder, Rado

doi:10.1159/000420223

Cited by 35 publications

(20 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Other anticoagulation methods for CRRT described in the literature with varying efficacy include regional heparinization, low molecular weight heparin, saline flushes, prostacyclin, nafamostat (serine proteinase inhibitor), hirudin, and regional citrate anticoagulation [11,12,13,14,15,16,17]. …”

Section: Common Anticoagulants Used In Paediatric Crrtmentioning

confidence: 99%

Prostacyclin as an Anticoagulant for Continuous Renal Replacement Therapy in Children

Deep

Zoha²,

Kukreja³

2017

Blood Purif

View full text Add to dashboard Cite

Effective delivery of continuous renal replacement therapy (CRRT) depends on the longevity of the filter and circuit used in the CRRT machine. Safe and effective anticoagulation is crucial for maintaining the patency of these circuits. In children, heparin and citrate are the commonly used anticoagulants but they are limited by serious side effects and thus calls for meticulous monitoring. In conditions where neither of these can be used, prostacyclin can be an effective alternative. Prostacyclin is a platelet inhibitor that can be safely used as an efficient anticoagulant in CRRT. When combined with heparin, it induces a heparin-sparing effect, which can reduce the dosage and side effects of heparin. Furthermore, there is no need for performing time-consuming monitoring tests. Although prostacyclin seems to be an attractive option, there is scanty evidence about its use as an anticoagulant in CRRT in children. We review the evidence and practicalities, and propose a guideline for the use of prostacyclin as an anticoagulant in children requiring CRRT.

show abstract

Section: Common Anticoagulants Used In Paediatric Crrtmentioning

confidence: 99%

Prostacyclin as an Anticoagulant for Continuous Renal Replacement Therapy in Children

Deep

Zoha²,

Kukreja³

2017

Blood Purif

View full text Add to dashboard Cite

show abstract

“…D'autres molécules ou combinaison de molécules ont été proposées, mais sans grand succès en raison de leur prix et de leur utilisation délicate. Ainsi, l'hirudine [59], la prostacycline [60], la combinaison héparine protamine [61], la prédilution sans ou avec des doses réduites d'héparine ont déjà été utilisées [62,63]. Récemment, plusieurs études ont montré l'efficacité, la simplicité et la sécurité d'une anticoagulation basée sur le citrate [64][65][66][67][68][69] alors que les premiers essais avaient été décevants en termes de sécurité et de complexité de protocole [70].…”

Section: Quelle Anticoagulation Choisir ?unclassified

L'épuration extrarénale appliquée au patient hospitalisé aux soins intensifs

Delanaye¹,

Dubois

Lambermont

et al. 2007

Néphrologie & Thérapeutique

View full text Add to dashboard Cite

RésuméLa mortalité reste élevée chez les patients de soins intensifs chez qui un traitement de suppléance rénale est nécessaire. Dans cet article, nous faisons le point sur les données récentes de la littérature qui améliorent la prise en charge de tels patients. Nous discutons successivement du choix du mode d'épuration (intermittente ou continue), de la membrane, de la dose à prescrire, du type d'anticoagulation et du moment où débuter la suppléance.Mots clés : anticoagulation ; épuration extrarénale ; hémodialyse ; hémofiltration ; membrane ; soins intensifs AbstractMortality remains high in intensive care patients with renal failure requiring extra corporeal blood purification. This article reviews the recent data that have led to the improvement of the care for such patients. We will discuss the criteria to determine the choice of the technique (intermittent or continuous), of the membrane, of the prescribing dose, and the type of anticoagulation and when to initiate such a treatment.

show abstract

“…Der darauffolgende Anstieg des intrazellulären cAMP-Spiegels führt über eine Erniedrigung des intrazellulären Kalziumspiegels zu den oben angeführten Effekten der Prostaglandine. Die antiaggregatorischen Prostaglandine bewirken eine temporäre Hemmung der Thrombozytenaktivierbarkeit während der Passage des Blutes durch die künstli-che Niere [9, 16,27,36,44,56,66,77].Wäh-rend einige Autoren [9, 15] vergleichbare Filterlaufzeiten mit Prostacyclin als Monotherapie erreichten, war die Hemmung der Thrombozytenfunktion mit Prostacyclin oder PGE 1 in der Studie von Salmon et al [61] bei 12 Patienten nicht ausreichend, um die Thrombinentstehung (gemessen am Plasmaspiegel von Thrombin-Antithrombin-Komplex) zu verhindern.Das kombinierte Antikoagulationsregime mit Prostaglandinen und unfraktioniertem Heparin oder niedermolekularem Heparin erwies sich bei der Mehrzahl der vergleichenden Untersuchungen als effizienter im Vergleich zur alleinigen Heparinisierung [27,39,44,77]. Aufgrund der unterschiedlichen Angriffspunkte im Gerinnungssystem wird die Kombinationstherapie mit Hemmung der plasmatischen Gerinnung durch Standardheparin oder niedermolekulare Heparine und Hemmung der zellulären Gerinnung durch antiaggregatorische Prostaglandine empfohlen [27,36,44,77].…”

Section: Antiaggregatorische Prostaglandineunclassified

Hämofiltration und Blutgerinnung

Kozek-Langenecker

2002

Der Anaesthesist

View full text Add to dashboard Cite

This paper reviews the pathophysiological processes occurring after contact of blood with artificial surfaces during continuous haemofiltration and the predominant role of platelets in the genesis of extracorporeal thrombosis. A basic prerequisite for effective renal replacement therapy is adequate anticoagulation in order to inhibit activation of coagulation and to avoid haemofilter clotting. Antithrombotic regimens controlling plasma coagulation activation and platelet-surface interactions, as well as methods of coagulation monitoring are reviewed. In patients at risk for bleeding, combined antithrombotic regimens with short-acting antiaggregatory prostaglandins and unfractionated or fractionated heparin were more effective in reducing bleeding complications and morbidity during and after haemofiltration then heparinisation alone. Heparinoids and hirudine are indicated in patients with heparin-induced thrombocytopenia II. In patients at risk for thromboembolism, regional citrate anticoagulation may be beneficial. Performing continuous haemofiltration without antithrombotic therapy is not recommended.

show abstract

Use of Prostacyclin as the Only Anticoagulant during Continuous Venovenous Hemofiltration

Cited by 35 publications

References 0 publications

Prostacyclin as an Anticoagulant for Continuous Renal Replacement Therapy in Children

Prostacyclin as an Anticoagulant for Continuous Renal Replacement Therapy in Children

L'épuration extrarénale appliquée au patient hospitalisé aux soins intensifs

Hämofiltration und Blutgerinnung

Contact Info

Product

Resources

About