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Titolo:
Use of a low-molecular-weight heparinoid (danaparoid sodium) for continuous renal replacement therapy in intensive care patients
Autore:
Lindhoff-Last, E; Betz, T; Bauersachs, R;
Indirizzi:
Univ Hosp Frankfurt, Dept Internal Med, Div Angiol, D-60590 Frankfurt, Germany Univ Hosp Frankfurt Frankfurt Germany D-60590 D-60590 Frankfurt, Germany Univ Hosp Frankfurt, Dept Internal Med, Div Nephrol, D-60590 Frankfurt, Germany Univ Hosp Frankfurt Frankfurt Germany D-60590 D-60590 Frankfurt, Germany
Titolo Testata:
CLINICAL AND APPLIED THROMBOSIS-HEMOSTASIS
fascicolo: 4, volume: 7, anno: 2001,
pagine: 300 - 304
SICI:
1076-0296(200110)7:4<300:UOALH(>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
INDUCED THROMBOCYTOPENIA; CRITICALLY ILL; HEMODIALYSIS; ORG-10172; ANTICOAGULANT; RISK; COMPLICATIONS; ANTIBODIES; FAILURE; UNIT;
Keywords:
low-molecular-weight heparinoid; danaparoid; renal insufficiency; renal replacement therapy; intensive care;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Lindhoff-Last, E Univ Hosp Frankfurt, Dept Internal Med, Div Angiol, Theodor Stern Kai 7, D-60590 Frankfurt, Germany Univ Hosp Frankfurt Theodor Stern Kai 7 Frankfurt Germany D-60590
Citazione:
E. Lindhoff-Last et al., "Use of a low-molecular-weight heparinoid (danaparoid sodium) for continuous renal replacement therapy in intensive care patients", CL APPL T-H, 7(4), 2001, pp. 300-304

Abstract

The purpose of this study was to evaluate the efficacy and safety of danaparoid in the treatment of critically ill patients with acute renal failure and suspected heparin-induced thrombocytopenia (HIT) needing renal replacement therapy (RRT). We conducted a retrospective analysis of 13 consecutive intensive care patients with acute renal failure and suspected HIT who weretreated with danaparoid for at least 3 days during RRT. In eight patients,continuous venovenous hemofiltration was performed. The mean infusion rateof danaparoid was 140 +/- 86 U/hour. Filter exchange was necessary every 37.5 hours. In five patients, continuous venovenous hemodialysis was used. Abolus injection of 750 U danaparoid was followed by a mean infusion rate of 138 +/- 122 U/hour. Filters were exchanged every 24 hours. In 7 of 13 patients. even a low mean infusion rate of 88 +/- 35 U/hour was efficient. Mean anti-Xa (aXa) levels were approximately 0.4 +/- 0.2 aXa U/mL. Persistent thrombocytopenia despite discontinuation of heparin treatment was observed in 9 of 13 patients, owing to disseminated intravascular coagulation (DIC). HIT was confirmed by an increase in platelet count and positive heparin-induced antibodies in 2 of 13 patients. No thromboembolic complications occur-red, but major bleeding was observed in 6 of 13 patients, which could be explained by consumption of coagulation factors and platelets due to DIC in 5 of 6 patients. Nine of 13 patients died of multiorgan failure or sepsis, or both. In none of these patients was the fatal outcome related to danaparoid treatment. In critically ill patients with renal impairment and suspected HIT, a bolus injection of 750 U danaparoid followed by a mean infusion rate of 50 to 150 U/hour appears to be a safe and efficient treatment optionwhen alternative anticoagulation is necessary.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 26/01/20 alle ore 10:11:30