Safety and Efficiency of Anticoagulation Therapy during CVVH in the Patients with MODS and High-Risk Bleeding
10.3969/j.issn.0253-9896.2014.06.024
- VernacularTitle:高出血风险MODS患者连续性血液滤过治疗抗凝方案的安全性及有效性分析
- Author:
Huiyu TIAN
;
Jianke LI
;
Shaohua SONG
;
Jie ZHANG
;
Yujie JIN
;
Peng LU
;
Xiufen YANG
- Publication Type:Journal Article
- Keywords:
multiple organ failure;
hemofiltration;
blood coagulation tests;
heparin;
high-risk bleeding;
continuous veno-venous hemofiltration;
coagulation function
- From:
Tianjin Medical Journal
2014;(6):595-598
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate safety and efficiency of anti-coagulation therapy in patients with high-risk of bleeding and multiple organ dysfunction syndrome (MODS) during continuous veno-venous hemofiltration (CVVH). Meth-ods Forty patients with high-risk bleeding MODS during CVVH in our hospital were divided into heparin-free group (A group) and low-dose heparin group (B group). Blood coagulation function, platelets counts, blood urea nitrogen, serum creati-nine, PaO2/FIO2 and Apache Ⅱ scores in two groups were tracked before treatment and 24 h, 48 h after treatment. Filter lifespan, median ventilation time, ICU admission time and bleeding complications were observed. Results (1)There was significant difference in levels of blood urea nitrogen, serum creatinine, PaO2/FIO2 and ApacheⅡscores at 24 h, 48 h after treatment between in low-dose heparin group and those in heparin-free group (P＜0.05). (2)Levels of activated partial thromboplastin time(APTT), thrombin time (TT) were prolonged. Platelets count were significantly lower at 24 h after treat-ment than that before treatment in low-dose heparin group. Levels of APTT, TT and platelets count had no changes with pro-longed time of CVVH therapy.(3)Average ventilation time, ICU admission time were obviously shorter in low-dose heparin group than that in heparin-free group. Filter lifespan was significant longer in low-dose heparin group than that in heparin-free group, (P＜0.05).(4)Bleeding in skin and mucosa was observed in 1 case in low-dose heparin group without other se-vere bleeding complications. Conclusion The results of monocentric study show that low dose of heparin ensure smooth op-eration of CVVH in patients with MODS and high-risk bleeding. The clinical application is safe and efficient.
