Document Detail

Safety of citrate based hemofiltration in critically ill patients at high risk for bleeding: a comparison with nadroparin.
MedLine Citation:
PMID:  16841283     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To study the incidence and severity of bleeding in high risk critically ill patients during high volume, citrate based continuous veno-venous hemofiltration (CVVH). DESIGN: A prospective 1-year observational cohort study comparing citrate based CVVH with nadroparin based CVVH. PROCEDURES: Critically ill patients with multiple organ dysfunction and in need of CVVH were observed for bleeding complications during their CVVH sessions. Pre-defined criteria determined that patients were treated with citrate based CVVH in case of active bleeding or increased risk for bleeding. Otherwise nadroparin was used as anticoagulant. Statistical and outcome methods: The incidence of bleeding complications, the number of transfused blood cell concentrates and the filter-run-time were recorded. Analyses were made by non-parametric tests. MAIN FINDINGS: Fifty-five patients received 272 CVVH sessions. In the citrate group 14.8% experienced a bleeding complication compared to 25% in the nadroparin group (p=0.04). The number of transfused red blood cell concentrates was not different between groups. The nadroparin group had a longer filter run time (median 31.5 hours versus 22.5 hours, p=0.0001). CONCLUSIONS: In high risk critically ill patients citrate based anticoagulation for CVVH is safe in terms of bleeding complications and transfusion requirements.
P H J Van der Voort; S R Postma; W P Kingma; E C Boerma; E N Van Roon
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  The International journal of artificial organs     Volume:  29     ISSN:  0391-3988     ISO Abbreviation:  Int J Artif Organs     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-07-14     Completed Date:  2007-01-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802649     Medline TA:  Int J Artif Organs     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  559-63     Citation Subset:  IM    
Department of Intensive Care, Medical Center Leeuwarden, Leeuwarden - The Netherlands.
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MeSH Terms
Anticoagulants / administration & dosage,  adverse effects
Citric Acid / administration & dosage,  adverse effects
Cohort Studies
Critical Illness
Erythrocyte Transfusion
Hemofiltration / adverse effects,  methods*
Hemorrhage / etiology,  prevention & control
Nadroparin / administration & dosage,  adverse effects
Prospective Studies
Risk Factors
Reg. No./Substance:
0/Anticoagulants; 0/Nadroparin; 77-92-9/Citric Acid

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