Anticoagulation strategies in continuous renal replacement therapy

被引：67

作者：

Legrand, Matthieu ^{[1
,2
]}

Tolwani, Ashita ^{[3
]}

机构：

[1] UCSF, Sch Med, Dept Anesthesia & Perioperat Care, Div Crit Care Med, San Francisco, CA USA

[2] INI CRCT Network, Nancy, France

[3] Univ Alabama Birmingham, Div Nephrol, Dept Internal Med, Birmingham, AL USA

来源：

SEMINARS IN DIALYSIS | 2021年 / 34卷 / 06期

关键词：

anticoagulation; citrate; continuous renal replacement therapy;

D O I：

10.1111/sdi.12959

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

The most common anticoagulant options for continuous renal replacement therapy (CRRT) include unfractionated heparin (UFH), regional citrate anticoagulation (RCA), and no anticoagulation. Less common anticoagulation options include UFH with protamine reversal, low-molecular weight heparin (LMWH), thrombin antagonists, and platelet inhibiting agents. The choice of anticoagulant for CRRT should be determined by patient characteristics, local expertise, and ease of monitoring. The Kidney Disease Improving Global Outcomes (KDIGO) acute kidney injury guidelines recommend using RCA rather than UFH in patients who do not have contraindications to citrate and are with or without increased risk of bleeding. Monitoring should include evaluation of the anticoagulant effect, circuit life, filter efficacy, and complications.

引用

页码：416 / 422

页数：7

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