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The impact of different heparin menstruums on hemodialysis using heparin coated hemophone

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Author:
No author available
Journal Title:
CHINESE CRITICAL CARE MEDICINE
Issue:
1
DOI:
10.3760/j.issn:1003-0603.2001.01.004
Key Word:
血液透析;溶媒;肝素;肝素吸附

Abstract: Objective:To further demonstrate the impact of different heparin menstruums〔normal saline(NS) or 5% glucose(GS)〕on heparin content bound by Hemophan,and to evaluate and optimize the safety and clinical outcome of hemodialysis using heparin coated hemophone(HCHD).Methods:Fourteen acute and chronic dialysis patients at high risk for bleeding,were enrolled in the crossover HCHD study.Each patient underwent HCHD in two different stages.All parameters were compared between NS group and GS group.Meanwhile, the effect of NS and 5% GS on heparin adsorption and the adsorption stability upon dialyzer was evaluated. The same patients on routine hemodialysis(HD) served as control group. Results:①During HCHD treatment,no sign of inducing or exacerbating bleeding was observed among the 14 patients at high risk for bleeding,and the existing bleeding was stopped in 3 of the patients with active hemorrhage.②Priming of heparin upon membrane by 5%GS showed 12.5% more adsorption of heprin〔(4 513±1 446)U〕 than by NS〔(4 011±444)U〕.Heparin release could be detected only in the flush of NS(4.4%).This suggested that 5%GS provided higher and more stable adsorption of hepatin than NS.③Level of plasma activated partial thromboplastin time(APTT) remained unchanged during HCHD compared with predialysis level.On the contrary,plasma APTT level enhanced 274%(P<0.01) in HD group.After the first session of dialysis,the value of the clearance for solutes,KT/V,fiber bundle volume,degree of clotting in dialyzers and extracorporeal circuits showed no significant difference among the three groups (all P>0.05).Conclusions:These results indicate NS,a polar solution,provided stable adsorption of heparin and effective anticoagulation in dialyzer and extracorporeal circuits,and no activation of coagulation pathways occurred in patients during HCHD.Therefore,HCHD is a simple,safe and efficient approach to managing the patients at high risk for bleeding,especially patients with active bleeding.

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