Thrombosis Research
Volume 126, Issue 1 , Pages 24-31 , July 2010

Heparin versus prostacyclin in continuous hemodiafiltration for acute renal failure: Effects on platelet function in the systemic circulation and across the filter

  • Andrea Arcangeli

      Affiliations

    • Istituto Anestesia e Rianimazione, Policlinico Agostino Gemelli, Catholic University School of Medicine, Largo Francesco Vito 1, 00168 Rome, Italy
    • Corresponding Author InformationCorresponding author. Istituto di Anestesia e Rianimazione Policlinico Universitario A. Gemelli Università Cattolica del Sacro Cuore, Rome, Italy. Largo A. Gemelli, 8, 00168, Rome, Italy. Tel.: +39 06 30154386; fax: +39 06 3013450.
  • ,
  • Bianca Rocca

      Affiliations

    • Department of Pharmacology, Catholic University School of Medicine, Largo Francesco Vito 1, 00168 Rome, Italy
  • ,
  • Gabriella Salvatori

      Affiliations

    • Istituto Anestesia e Rianimazione, Policlinico Agostino Gemelli, Catholic University School of Medicine, Largo Francesco Vito 1, 00168 Rome, Italy
  • ,
  • Mariano Ciancia

      Affiliations

    • Istituto Anestesia e Rianimazione, Policlinico Agostino Gemelli, Catholic University School of Medicine, Largo Francesco Vito 1, 00168 Rome, Italy
  • ,
  • Raimondo De Cristofaro

      Affiliations

    • Department of Internal Medicine, Catholic University School of Medicine, Largo Francesco Vito 1, 00168 Rome, Italy
  • ,
  • Massimo Antonelli

      Affiliations

    • Istituto Anestesia e Rianimazione, Policlinico Agostino Gemelli, Catholic University School of Medicine, Largo Francesco Vito 1, 00168 Rome, Italy

Received 24 November 2009 ,Revised 27 January 2010 ,Accepted 27 January 2010.

References 

  1. Bellomo R, Ronco C. Renal replacement therapy in the intensive care unit. Crit Care Resusc. 1999;1:13–24
  2. Van de Wetering J, Westendorp R, Van der Hoeven JG, Stolk B, Feuth JD, Chang PC. Heparin use in continuous renal replacement procedures. The struggle between filter clotting and patient hemorrhage. J Am Soc Nephrol. 1996;7:145–150
  3. Tillman J. Heparin versus citrate for anticoagulation in critically ill patients treated with continuous renal replacement therapy. Nurs Crit Care. 2009;14:191–199
  4. Oudemans-van Straaten HM, Wester JPJ, de Pont ACJM, Schetz MR. Anticoagulation strategies in continuous renal replacement therapy: can the choice be evidence based?. Intensive Care Med. 2006;32:188–202
  5. Jeffrey RF. A, Douglas JT, Will EJ, Davison AM. Anticoagulation with low molecular weight heparin (Fragmin) during continuous hemodialysis in the intensive care unit. J Artif Organs. 1993;17:717–720
  6. Reeves JH, Cumming AR, Gallagher L, O'Brien JL, Santamaria JD. A controlled trial of low-molecular-weight heparin (dalteparin) versus unfractionated heparin as anticoagulant during continuous veno-venous hemodialysis with filtration. Crit Care Med. 1999;27:2224–2228
  7. Vargas Hein O, von Heymann C, Lipps M, Lipps M, Ziemer S, Ronco C, et al. Hirudin versus heparin for anticoagulation in continuous renal replacement therapy. Intensive Care Med. 2001;27:673–679
  8. Kozeck-Langenecker SA, Kettner SC, Oismuller C, Gonano C, Speiser W, Zimpfer M. Anticoagulation with prostaglandin E1 and unfractioned heparin during continuous veno-venous hemofiltration. Crit Care Med. 1998;26:1208–1212
  9. Ponikvar R, Kandus A, Buturovic J, Kveder R. Use of prostacyclin as the only anticoagulant during continuous veno-venous hemofiltration. Contrib Nephrol. 1991;93:218–220
  10. Langenecker SA, Felfernig M, Werba A, Mueller CM, Chiari A, Zimpfer M. Anticoagulation with Prostacyclin and Heparin during continuous venovenous hemofiltration. Crit Care Med. 1994;22:1774–1781
  11. Gainza FJ, Quintanilla N, Pijoan JI, Delgado S, Urbizu JM, Lampreabe I. Role of Prostacyclin (epoprostenol) as anticoagulant in continuous renal replacement therapies: efficacy, security and cost analysis. J Nephrol. 2006;19:648–655
  12. Scheeren T, Radermacher P. Prostacyclin (PGI2). New aspects of an old substance in the treatment of critically ill patients. Intensive Care Med. 1997;23:146–158
  13. Davenport A, Will EJ, Davison AM. Comparison of the use of standard heparin and prostacyclin anticoagulation in spontaneous and pump-driven extracorporeal circuits in patients with combined acute renal and hepatic failure. Nephron. 1994;66:431–437
  14. Davenport A, Will EJ, Davison AM. Adverse effect of prostacyclin administered directly into patients with combined renal and respiratory failure prior to dialysis. Intensive Care Med. 1990;16:431–435
  15. Balik M, Waldauf P, Plàšil P, Pachl J. Prostacyclin versus citrate in continuous haemodiafiltration: an observational study in patients with high risk of bleeding. Blood Purif. 2005;23:325–329
  16. Van der Voort PHJ, Gerritsen RT, Kuiper MA, Egbers PH, Kingma WP, Boerma EC. Filter run time in CVVH: pre- versus post-dilution and Nadroparin versus regional Heparin-Protamine anticoagulation. Blood Purif. 2005;23:175–180
  17. Cointault O, Kamar N, Bories P, Lavayssiere L, Angles O, Rostaing L, et al. Regional citrate anticoagulation in continuous venovenous haemodiafiltration using commercial solutions. Nephrol Dial Transplant. 2004;19:171–178
  18. Tolwani AJ, Campbell RC, Schenk MB, Allon M, Warnock DG. Simplified citrate anticoagulation for continuous renal replacement therapy. Kidney Int. 2001;60:370–374
  19. Hofmann RM, Maloney C, Ward DM, Becker BN. A novel method for regional citrate anticoagulation in continuous veno-venous hemofiltration (CVVHF). Ren Fail. 2002;24:325–335
  20. Gabutti L, Marone C, Colucci G, Duchini F, Schönholzer C. Citrate anticoagulation in continuous venovenous hemodiafiltration: a metabolic challenge. Intensive Care Med. 2002;28:1419–1425
  21. Tan HK, Baldwin I, Bellomo R. Continuous veno-venous hemofiltration without anticoagulantion in high-risk patients. Intensive Care Med. 2000;26:1652–1657
  22. Bellomo R, Ronco C, Kellum JA, Mehta RL. Palevsky P; Acute Dialysis Quality Initiative workgroup. Acute renal failure-definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care. 2004;8:R204–R212
  23. Dordoni PL, Frassanito L, Bruno MF, Proietti R, de Cristofaro R, Ciabattoni G, et al. In vivo and in vitro effects of different anaesthetics on platelet function. Br J Haematol. 2004;125:79–82
  24. Parent F, Maitre S, Meyer G, Raherison C, Mal H, Lancar R, et al. Diagnostic value of D-dimer in patients with suspected pulmonary embolism: results from a multicentre outcome study. Thromb Res. 2007;120:195–200
  25. Pottier P, Fouassier M, Hardouin JB, Volteau C, Planchon B. D-dimers, thrombin-antithrombin complexes, and risk factors for thromboembolism in hospitalized patient. Clin Appl Thromb Hemost. 2009;15:666–675
  26. Cauchie P, Cauchie Ch, Boudjeltia KZ, Carlier E, Deschepper N, Govaerts D, et al. Diagnosis and prognosis of overt disseminated intravascular coagulation in a general hospital - meaning of the ISTH score system, fibrin monomers, and lipoprotein-C-reactive protein complex formation. Am J Hematol. 2006;81:414–419
  27. Gachet C. Receptors, platelet function and pharmacological implications. Thromb Haemost. 2008;99:466–472
  28. Fiaccadori E, Maggiore U, Rotelli C, Minari M, Melfa L, Cappè G, et al. Continuous haemofiltration in acute renal failure with prostacyclin as the sole anti-haemostatic agent. Intensive Care Med. 2002;28:586–593
  29. Fabbri LP, Nucera M, Al Mayan M, Becchi G. Regional anticoagulation and aggregation for CVVH in critically ill patients: a prospective, randomized, controlled pilot study. In: Acta Aneasthesiol Scand. 2009;Epub ahead of print
  30. Kozek-Langenecker SA. Effect of prostacyclin on platelets, polymorphonuclear cells, and heterotypic cell aggregation during hemofiltration. Crit Care Med. 2003;31:864–868
  31. Bouman C, de Pont AC, Meijers J, Bakhtiari K, Roem D, Zeerleder S, et al. The effects of continuous venovenous hemofiltration on coagulation activation. Crit Care. 2006;10:R150–R157
  32. Cardigan RA. Activation of the tissue factor pathway occurs during continous venovenous hemofiltration. Kidney Int. 1999;55:1568–1574
  33. Xiao Z, Theroux P. Platelet activation with unfractionated heparin at therapeutic concentrations and comparison with a low-molecular-weight heparin and with a direct thrombin inhibitor. Circulation. 1998;97:251–256
  34. Landolfi R, De Candia E, Rocca B, Ciabattoni G, Antinori A, Masetti R, et al. Effects of unfractionated and low molecular weight heparins on platelet thromboxane biosynthesis “in vivo”. Thromb Haemost. 1994;72:942–946
  35. Salzman EW, Rosenberg RD, Smith MH, Lindon JN, Favreau L. Effect of heparin and heparin fractions on platelet aggregation. J Clin Invest. 1980;65:64–73
  36. Michelson AD, Barnard MR, Hechtman HB, Ragno G, Pivacek LE, Hechtman HB, et al. In vivo tracking of platelets: circulating degranulated platelets rapidly lose surface P-selectin but continue to circulate and function. Proc Natl Acad Sci USA. 1996;93:11877–11882
  37. Mulder J, Tan HK, Bellomo R, Silvester W. Platelet loss across the hemofilter during continuous hemofiltration. Int J Art Org. 2003;26:906–912
  38. Hofbauer R. Effect of anticoagulation on blood membrane interactions during hemodialysis. Kidney Int. 1999;56:1578–1583
  39. Boldt J, Menges T, Wollbruck M, Hammermann H, Hempelmann G. Continuous hemofiltration and platelet function in critically ill patients. Crit Care Med. 1994;22:1155–1160
  40. Cianciolo G, Stefoni S, Donati G, De Pascalis A, Iannelli S, Manna C, et al. Intra- and post-dialytic platelet activation and PDGF-AB release: cellulose diacetate vs polysulfone membranes. Nephrol Dial Transplant. 2001;16:1222–1229
  41. Boldt J, Menges T, Wollbruck M, Sonneborn S, Hempelmann G. Platelet function in critically ill patients. Chest. 1994;106:899–903
  42. Chanard J, Lavaud S, Randoux C, Rieu P. New insights in dialysis membrane biocompatibility: relevance of adsorption properties and heparin binding. Nephrol Dial Transplant. 2003;18:252–257

PII: S0049-3848(10)00103-9

doi: 10.1016/j.thromres.2010.01.048

Thrombosis Research
Volume 126, Issue 1 , Pages 24-31 , July 2010