Supervivencia de circuitos de técnicas de depuración extrarrenal continua en pacientes críticos con o sin anticoagulación convencionalestudio observacional prospectivo

  1. Sanz Ganuza, M.
  2. Hidalgo Martínez, F.
  3. García-Fernández, N.
Journal:
Anales del sistema sanitario de Navarra

ISSN: 1137-6627

Year of publication: 2017

Volume: 40

Issue: 1

Pages: 77-84

Type: Article

DOI: 10.23938/ASSN.0008 DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Anales del sistema sanitario de Navarra

Abstract

Background. The aim of this study was to describe the efficacy, security and viability of an anticoagulation system with continuous infusion of unfractionated heparin (UFH) versus one without any type of anticoagulant using 0.9% physiological saline washings, in critically ill patients with continuous renal replacement therapy (CRRT) and different risks of bleeding. Methods. From October 2013 to April 2015 we conducted an observational prospective study in the intensive care unit (ICU). Sixty-one patients with acute kidney injury (AKI) and requiring CRRT were included, with 122 filters. Patients and filters were divided in two groups: anticoagulated (AC) and not anticoagulated (No AC). The main outcome measure was filter life span. Different analytical parameters were also collected at the beginning of treatment and at the moment of circuit coagulationResults. The number of patients was similar in both groups. We did not find statistically significant differences between the two groups in filter life span (30.5 hours AC vs 34.9 hours No AC). Patients with increased morbidity (severe thrombocytopenia, coagulopathy, etc.) were included in the group that did not received anticoagulation but saline flushes.Conclusions. CRRT without anticoagulation with saline flushes is a viable, safe and effective strategy in critically ill patients with high risk of bleeding. This approach achieves a circuit life span similar to that observed in anticoagulated patients with UFH; avoiding the risks and costs associated with anticoagulation. 

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