Iloprost for additional anticoagulation in continuous renal replacement therapy--a pilot study.
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.
Birnbaum
Jürgen
J
Department of Anesthesiology and Intensive Care Medicine, Campus Charité Mitte and Campus Charité Virchow-Klinikum, Charité-University Medicine, Berlin, Germany. juergen.birnbaum@charite.de
Spies
Claudia D
CD
Klotz
Edda
E
Hein
Ortrud Vargas
OV
Morgera
Stanislao
S
Schink
Tania
T
Ziemer
Sabine
S
Grund
Mona S
MS
Saalmann
René
R
Kox
Wolfgang J
WJ
Lehmann
Christian
C
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
D000925:Anticoagulants; D015415:Biomarkers; D010975:Platelet Aggregation Inhibitors; D006493:Heparin; D016285:Iloprost