Monitoring of low molecular weight heparin anticoagulation during haemodialysis with a Sonoclot Analyzer.
OBJECTIVE
Sonoclot was used in this study to monitor low molecular weight heparin (LMWH) during haemodialysis.


METHODS
Two different intravenous doses (standard / half-dose) of dalteparin were studied in eight patients. Blood was sampled for coagulation analyses with Sonoclot, thrombin-antithrombin (TAT) and anti-Xa. A visual fibrin deposition score (VFS) in the venous drip chamber was also evaluated.


RESULTS
All patients completed their dialysis. There was a progressive increase in TAT levels, which correlated to the dalteparin dose. Significant differences (p<0.05) were found for TAT, VFS and Sonoclot celite-activated clotting time (SonACT) between the different LMWH dosages. TAT and Sonoclot correlated to each other, but not to the VFS. SonACT was significantly increased at two hours, with the high dalteparin dose compared to the lower dose.


CONCLUSIONS
Both Sonoclot and TAT failed to predict the VFS. No patient had any clinical clotting events and all dialyses were completed successfully.
Skane University Hospital, Lund, Skane, Sweden. ulf.schott@skane.se
Ulf
U
Schött
Lars Göran
LG
Nilsson
Marcus
M
Broman
Martin
M
Engström
D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000097:blood*; D000991:Antithrombins / Q000032:analysis; D001777:Blood Coagulation / Q000187:drug effects; D001780:Blood Coagulation Tests / Q000295:instrumentation; D018592:Cross-Over Studies; D017985:Dalteparin / Q000008:administration & dosage / Q000097:blood*; D016903:Drug Monitoring / Q000379:methods; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods*; D013916:Thrombelastography; D013917:Thrombin / Q000032:analysis
D000925:Anticoagulants; D000991:Antithrombins; D013917:Thrombin; D017985:Dalteparin