The Journal of Informed Pharmacotherapy 2004;15:404.
Karmin G. Ip, B.Sc.(Pharm.), Sean K. Gorman, B.Sc.(Pharm.), Pharm.D., Jane de Lemos, B.Sc.(Pharm.), Pharm.D., Richard S. Slavik, B.Sc.(Pharm.), Pharm.D.
Clinical Services Unit Pharmaceutical Sciences, Vancouver General Hospital, Faculty of Pharmaceutical Sciences, University of British Columbia
Canadian Society of Hospital Pharmacists (British Columbia Branch) Residency Research Presentation Night, Vancouver, British Columbia, Canada. May 2003.
Continuous renal replacement therapy (CRRT) is complicated by filter clotting necessitating anticoagulation to prolong filter life.The primary aims were to determine the incidence of CRRT use, to characterize patients who receive CRRT, to determine the effectiveness of the CRRT heparin protocol in maintaining aPTT within the desired range, to determine filter life achieved with the protocol, and to characterize its safety.
A major Canadian tertiary adult acute care teaching hospital.
Prospective, observational study performed in a 25-bed medical/surgical ICU. Eighteen consecutive patients were enrolled.
The incidence of CRRT use was 5% and the protocol was used in 42% of cases. The average time to desired aPTT with protocol was 19.3 hr. Of all aPTTs drawn during protocol, 28% were within the desired range. The major reason for filter discard was filter clotting (77.4%). The overall average filter life was 13.4 hr. The average life of filters discarded due to clots was 12.4 hr. Time to filter clotting on protocol was longer than those not exposed to anticoagulation (14.2 hr vs. 9.5 hr, p = 0.031). There were no major bleeding events.
The protocol appears safe and may prolong filter life compared to no anticoagulation despite its inefficiency in maintaining goal aPTT.
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