A pilot randomized controlled crossover study comparing regional heparinization to regional citrate anticoagulation for continuous venovenous hemofiltration.
OBJECTIVE
To evaluate the efficacy and safety of a regional heparinization and a regional citrate method of anticoagulation in CVVH.


METHODS
Randomized controlled cross-over study.


METHODS
Ten critically ill patients with acute renal failure.


METHODS
ICU of tertiary hospital.


METHODS
CVVH was performed with pre-filter fluid replacement at 2000 ml/h and a blood flow rate of 150 ml/min. Regional heparinization was by the administration of heparin pre-filter at 1500 IU/h and protamine post-filter at 15 mg/h. Regional citrate anticoagulation was by means of a citrate-based replacement fluid (14 mmol/L) administered pre-dilution.


RESULTS
We studied nine males and one female. The mean age and APACHE II score were 70.5 and 17 respectively. Median circuit life was 13 hours (IQR 9.28) for the regional heparinization method compared to 17 hours (IQR 12,19.5) for the regional citrate method (p=0.77). There were no episodes of bleeding in either group.


CONCLUSIONS
Regional heparinization and regional citrate anticoagulation achieve similar circuit life in critically ill patients receiving CVVH.
Fealy
N
N
Department of Intensive Care, Austin Hospital, Melbourne - Australia.
Baldwin
I
I
Johnstone
M
M
Egi
M
M
Bellomo
R
R
D058186:Acute Kidney Injury / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D002118:Calcium / Q000627:therapeutic use; D019343:Citric Acid / Q000627:therapeutic use*; D003422:Critical Care; D018592:Cross-Over Studies; D005260:Female; D015312:Hemodialysis Solutions / Q000627:therapeutic use; D006440:Hemofiltration / Q000379:methods*; D006493:Heparin / Q000627:therapeutic use*; D006494:Heparin Antagonists / Q000627:therapeutic use; D006801:Humans; D008274:Magnesium / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011479:Protamines / Q000627:therapeutic use; D012449:Safety; D013997:Time Factors; D016896:Treatment Outcome
D000925:Anticoagulants; D015312:Hemodialysis Solutions; D006494:Heparin Antagonists; D011479:Protamines; D019343:Citric Acid; D006493:Heparin; D008274:Magnesium; D002118:Calcium