SciELO - Scientific Electronic Library Online

 
vol.21 número1Déficit de vitamina D en pacientes en hemodiálisis y factores relacionados índice de autoresíndice de assuntospesquisa de artigos
Home Pagelista alfabética de periódicos  

Serviços Personalizados

Journal

Artigo

Indicadores

Links relacionados

  • Em processo de indexaçãoCitado por Google
  • Não possue artigos similaresSimilares em SciELO
  • Em processo de indexaçãoSimilares em Google

Compartilhar


Enfermería Nefrológica

versão On-line ISSN 2255-3517versão impressa ISSN 2254-2884

Resumo

ARAGO SORROSAL, Sergi et al. Two anticoagulation methods in continuous extra-renal depuration techniques. Enferm Nefrol [online]. 2018, vol.21, n.1, pp.9-17. ISSN 2255-3517.  http://dx.doi.org/10.4321/s2254-28842018000100002.

Introduction:

Continuous extra-renal depuration techniques are the therapy of choice in critically ill patients. But, they are not exempt from complications such as the coagulation of the extracorporeal circuit. The drug traditionally used for anticoagulation is sodium heparin. Although other methods of anticoagulation, such as citrate, are also used.

Objective:

To evaluate the efficacy and safety of two anticoagulation methods in patients treated with continuous therapies, in intensive care units of the Hospital Clinic of Barcelona.

Material and Method:

A retrospective observational study with 54 subjects was carried out. The criteria of acute renal insufficiency, described in the protocol "Guide for renal replacement therapy in acute renal failure at the Hospital Clínic" were applied. Patients were treated by hemodiafiltration, combining convection and diffusion therapies; with filtration fraction < 25%, and effluent dose of 30ml/kg/h. Twenty-seven subjects performed hemodiafiltration, pre-filter replacement and anticoagulation with sodium heparin. The rest, hemodiafiltration, post-filter replacement and anticoagulation with citrate. Episodes of bleeding and duration in hours of the extracorporeal circuits were evaluated during 72 hours of therapy.

Results:

Citrate demonstrated a greater survival of filters (95% CI, MD 65, 44.00-72.00 vs. MD 36.00, 15.00-22.00, p=0.02). Patients treated with heparin had more episodes of bleeding, without statistically significant differences (95% CI, n=6 vs. n=9, p=0.537). There was an episode of hypocalcemia in the citrate group, corrected according to protocol. In the heparin group, there were no cases of heparin-induced thrombocytopenia.

Conclusions:

The present study demonstrates greater efficacy in the survival of filters in the citrate group.

Palavras-chave : citrate; heparin; regional anticoagulation; Continuous therapy; Extra-renal depuration; Acute renal failure.

        · resumo em Espanhol     · texto em Espanhol     · Espanhol ( pdf )