title: Iloprost for additional anticoagulation in continuous renal replacement therapy--a pilot study.
abstract: OBJECTIVE
  The aim of this pilot study was to compare the effect of heparin anticoagulation with and without iloprost administration during continuous renal replacement therapy (CRRT) in critically ill patients.
  
  
  METHODS
  In a prospective, randomized, controlled pilot study at an intensive care unit at a university hospital, 20 patients requiring CRRT were investigated. Patients were allocated into two groups: group 1, the heparin group; and group 2, the heparin plus 1 ng/kg/min iloprost. In both groups, activated partial thromboplastin time (aPTT) was adjusted to 40-50 sec. Observation time was a maximum of 7 days.
  
  
  RESULTS
  Median filter run time was significantly prolonged by iloprost administration to a median of 14 h (13-26 h) compared to 10 h (4-12 h) in the heparin group (p = 0.004). A decrease in platelet count was attenuated by iloprost administration (p = 0.012). There were no bleeding complications in either group. Hemofiltration efficiency did not differ significantly between the groups.
  
  
  CONCLUSIONS
  Additional administration of iloprost prolonged the filter run time of continuous veno-venous hemofiltration (CVVH) in this setting and attenuated the fall in platelet count during CRRT.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Campus Charité Mitte and Campus Charité Virchow-Klinikum, Charité-University Medicine, Berlin, Germany. juergen.birnbaum@charite.de
authors.forename: Jürgen
authors.initials: J
authors.lastname: Birnbaum
authors.forename: Claudia D
authors.initials: CD
authors.lastname: Spies
authors.forename: Edda
authors.initials: E
authors.lastname: Klotz
authors.forename: Ortrud Vargas
authors.initials: OV
authors.lastname: Hein
authors.forename: Stanislao
authors.initials: S
authors.lastname: Morgera
authors.forename: Tania
authors.initials: T
authors.lastname: Schink
authors.forename: Sabine
authors.initials: S
authors.lastname: Ziemer
authors.forename: Mona S
authors.initials: MS
authors.lastname: Grund
authors.forename: René
authors.initials: R
authors.lastname: Saalmann
authors.forename: Wolfgang J
authors.initials: WJ
authors.lastname: Kox
authors.forename: Christian
authors.initials: C
authors.lastname: Lehmann
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000628:therapy; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000925:Anticoagulants / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation / Q000187:drug effects; D004359:Drug Therapy, Combination; D005260:Female; D006440:Hemofiltration / Q000295:instrumentation; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D016285:Iloprost / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D010865:Pilot Projects; D015539:Platelet Activation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D010976:Platelet Count; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D015415:Biomarkers; D010975:Platelet Aggregation Inhibitors; D006493:Heparin; D016285:Iloprost