[Management of intraoperative anticoagulantless CHD with EVAL-dialyzer in four patients on maintenance hemodialysis].
It is difficult to correct fluid balance during operation in patients under hemodialysis. We managed intraoperative anticoagulantless continuous hemodialysis (CHD) with ethylene vinyl alcohol copolymer (EVAL) dialyzer in four patients on maintenance hemodialysis. All patients could be managed satisfactorily with no coagulation. Only in the first patient, we used nafamostat mesilate to avoid coagulation in the dialyzer. In this patient, activated clotting time (ACT) was 151 seconds. Their recovery from anesthesia was good, and they showed no complications perioperatively. This is a good method to manage these patients during operation, because EVAL dialyzer is cheap and we need not take care of hemorrhage. Using a small amount of nafamostat mesilate may be useful to avoid coagulation.
Wake
Mikiko
M
Department of Anesthesia, St. Mary's Hospital, Himeji 670-0801.
Sanagawa
Yumi
Y
Tanaka
Yoko
Y
D000328:Adult; D000368:Aged; D001550:Benzamidines; D005260:Female; D006146:Guanidines / Q000008:administration & dosage; D006801:Humans; D007430:Intraoperative Care; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011145:Polyvinyls; D006435:Renal Dialysis / Q000295:instrumentation / Q000379:methods*
D001550:Benzamidines; D006146:Guanidines; D011145:Polyvinyls; C016438:ethylenevinylacetate copolymer; C032855:nafamostat