geoscience.net logo
+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Continuous haemofiltration in acute renal failure with prostacyclin as the sole anti-haemostatic agent


, : Continuous haemofiltration in acute renal failure with prostacyclin as the sole anti-haemostatic agent. Intensive Care Medicine 28(5): 586-593

To investigate the safety and efficacy of a synthetic prostacyclin analogue (epoprostenol) for circuit maintenance during continuous veno-venous haemofiltration (CVVH) in patients with acute renal failure (ARF). Observational case study. University-affiliated six-bed intermediate renal care unit in a nephrology and internal medicine department of a 1300-bed teaching hospital. A consecutive series of critically ill ARF patients in whom prostacyclin was the sole anti-haemostatic agent used for CVVH. Bicarbonate-based CVVH in pre-dilution (1.5 l/h); blood flow rate at 200 ml/min; prostacyclin at 4 ng/kg per min infusion in the extracorporeal circuit before the haemofilter. Fifty-one ARF patients (mean APACHE II 27.2, SD 7.8; acute tubular necrosis in 44/51, 83%; mechanical ventilation 14/51, 21%; in-hospital mortality 28/51, 54%) underwent CVVH for a total of 4040 h (230 circuits, median number 4 circuits per patient, range 1-13). Four patients out of 51 (7.8%) experienced major bleeding during CVVH (1.0 episode per 1000 patient-hours of treatment; 95%CI, 0.4-2.6); no death could be attributed to haemorrhage. Therapeutic intervention for hypotension (fluids and/or vasopressors) was required in 15.5% of the CVVH sessions monitored. The median duration of the circuit was 15.0 h (95% CI, 13.0-16.5). The use of prostacyclin as the sole anti-haemostatic agent for CVVH entails a low risk of haemorrhagic complications, while maintaining the patency of the circuit long enough to allow the delivery of an adequate dose of renal replacement therapy. Further studies are needed to compare this technique to other anti-haemostatic strategies for CVVH.

US$19.90

PMID: 12029407

DOI: 10.1007/s00134-002-1249-y


Other references

Shah, N.N.; Stonecypher, M.; Gopal, P.; Luger, S.; Bagg, A.; Perl, A., 2016: Acute promyelocytic leukemia presenting as a paraspinal mass. Acute promyelocytic leukemia (APL) is a distinct subtype of acute myeloid leukemia (AML) that is characterized by a balanced translocation between chromosomes 15 and 17 [t(15;17)], which results in the fusion of the promyelocytic leukemia (PML) an...

Flachenecker, P.; Rieckmann, P., 2004: Health outcomes in multiple sclerosis. Economic considerations are increasingly important in the evaluation of innovative medical technologies. In the past few years, evaluations of cost and cost-effectiveness analysis became a popular topic for multiple sclerosis research. Here, we re...

Nielsen, S.; Eggers, B.; Collins, S., 2000: The influence of seawalls and revetments on the presence of seagrass in the Indian River Lagoon, a preliminary study. Various types of shoreline stabilization methods have been used in the Indian River Lagoon to prevent erosion caused by wave action. These include: vertical seawalls, smooth revetments, riprap revetments (all collectively referred to as hardened s...

Rieche, A.; Hilgetag, G.; Martini, A.; Philippson, R., 1961: New compounds with bactericidal, fungicidal and inhibitory effects on the growth of viruses. II. Thiourethane. Archiv der Pharmazie 294/66: 201-209

Christadoss, P.; David, C.; Goluszko, E.; Shenoy, M., 1993: T cell receptor V-beta gene deletion in V-beta-c mutant mice augments development of autoimmune myasthenia gravis. Journal of Cellular Biochemistry Supplement 0(17 PART C): 78

Arkhipova, O.G.; Medved', T.Y.; Rudomino, M.V.; Kabachnik, M.I., 1965: Some problems in the action mechanism of the disodium salt of ethylenediamine bisisopropylphosphonic acid. A C14-labelled preparation was synthesized and used to study the ways in which Phosphicin is excreted from the body. 1 ml or a 2% solution was administered to white rats orally and intraperitoneally. When administered parenterally most of the prep...

Liu, G., 1996: Problems in dynamic electrocardiography. Zhonghua Nei Ke Za Zhi 35(3): 149-150

Debabov, V.G.; Kozlov, J.I.; Khurges, E.M.; Livshits, V.A.; Zhdanova, N.I.; Gusyatiner, M.M.; Sokolov, A.K.; Bachina, T.A., 1997: Bacterial strain of escherichia coli VNII genetika 472T23 as the producer of L-threonine. Official Gazette of the United States Patent & Trademark Office Patents 1198(3): 1822, May 20

Mueller, E.; Merker, G.; Wuthe, H.; Vogel, J., 1980: Reference values of respiratory parameters in children 6. reference values of nitrogen washout parameters. Reference values for N2 washout parameters detecting ventilatory inhomogeneities in the lungs were estimated from multibreath N2 washout curves measured in 577 children aged between 6 and 17 yr. The following parameters were calculated by a comput...

Abrahin, O.; Rodrigues, R.P.; Nascimento, V.C.; D.S.lva-Grigoletto, M.E.; Sousa, E.C.; Marçal, A.C., 2015: Single- and multiple-set resistance training improves skeletal and respiratory muscle strength in elderly women. Aging involves a progressive reduction of respiratory muscle strength as well as muscle strength. Compare the effects of resistance training volume on the maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), functional performanc...