PMID- 17952356
OWN - NLM
STAT- MEDLINE
DCOM- 20080731
LR  - 20190917
IS  - 0104-4230 (Print)
IS  - 0104-4230 (Linking)
VI  - 53
IP  - 5
DP  - 2007 Sep-Oct
TI  - [Anticoagulation in continuous renal replacement therapies (CRRT)].
PG  - 451-5
AB  - Continuous renal replacement therapies (CRRT) are commonly used in the majority 
      of critically ill patients who need dialysis. Treatment success depends on an 
      efficient anticoagulation protocol devised to maintain the dialysis circuit 
      unclotted, with minimal complications such as bleeding due to excessive 
      anticoagulation. Several features can contribute to dialysis circuit thrombosis, 
      such as the speed of pump blood flow, dialysis catheter, type of dialyzer 
      membrane and also, the type of technique prescribed. Unfractioned heparin (UFH) 
      is the anticoagulant most used in CRRT. Recently, low-molecular weight heparins 
      (LMWH) have been shown to be safe and effective drugs for this purpose. In 
      critically ill patients, who frequently have contraindications to systemic 
      anticoagulation, regional anticoagulation with trisodium citrate is an 
      increasingly accepted method due to its safety and efficiency if applied under 
      strict metabolic control. Regional anticoagulation with UFH/protamin now has 
      limited use because of side effects related to protamin. If the patient has 
      contraindication to systemic anticoagulation or if regional anticoagulation with 
      citrate is not available, continuous flushing of circuit dialysis with saline is 
      the only applicable alternative. In patients with contraindication to 
      heparinization, new drugs not yet available in Brazil, such as prostaglandins, 
      recombinant hirudin, argatroban and nafamostat can be used.
FAU - Garces, Erwin Otero
AU  - Garces EO
AD  - Programa de Pos-Graduacao em Ciencias Medicas, Nefrologia e Servico de Nefrologia 
      do Hospital de Clinicas de Porto Alegre, Faculdade de Medicina, Universidade 
      Federal do Rio Grande do Sul, Porto Alegre, RS.
FAU - Victorino, Josue Almeida
AU  - Victorino JA
FAU - Veronese, Francisco Verisimo
AU  - Veronese FV
LA  - por
PT  - Journal Article
PT  - Review
TT  - Anticoagulacao em terapias continuas de substituicao renal.
PL  - Brazil
TA  - Rev Assoc Med Bras (1992)
JT  - Revista da Associacao Medica Brasileira (1992)
JID - 9308586
RN  - 0 (Anticoagulants)
RN  - 0 (Citrates)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 451W47IQ8X (Sodium Chloride)
SB  - IM
MH  - Acute Kidney Injury/therapy
MH  - Anticoagulants/*therapeutic use
MH  - Citrates/therapeutic use
MH  - Contraindications
MH  - Disinfection
MH  - Heparin, Low-Molecular-Weight/*therapeutic use
MH  - Humans
MH  - Intensive Care Units
MH  - Renal Dialysis/methods
MH  - *Renal Replacement Therapy/adverse effects/instrumentation/standards
MH  - Sodium Chloride
MH  - Thrombosis/etiology/*prevention & control
RF  - 35
EDAT- 2007/10/24 09:00
MHDA- 2008/08/01 09:00
CRDT- 2007/10/24 09:00
PHST- 2006/12/13 00:00 [received]
PHST- 2007/06/25 00:00 [accepted]
PHST- 2007/10/24 09:00 [pubmed]
PHST- 2008/08/01 09:00 [medline]
PHST- 2007/10/24 09:00 [entrez]
AID - S0104-42302007000500023 [pii]
AID - 10.1590/s0104-42302007000500023 [doi]
PST - ppublish
SO  - Rev Assoc Med Bras (1992). 2007 Sep-Oct;53(5):451-5. doi: 
      10.1590/s0104-42302007000500023.