Filter run time in CVVH: pre- versus post-dilution and nadroparin versus regional heparin-protamine anticoagulation

Blood Purif. 2005;23(3):175-80. doi: 10.1159/000083938. Epub 2005 Feb 10.

Abstract

Background/aims: To study the effect of different modes of continuous veno-venous haemofiltration (CVVH) on filter run time (FRT).

Methods: We studied, in two consecutive prospective, randomised and crossover studies, 16 and 15 patients with acute renal failure during critical illness. Study A compared pre- versus post-dilution, and study B compared regional anticoagulation with heparin (pre-filter) and protamine (post-filter) (HP) versus nadroparin (NP) pre-filter. All CVVH sessions were standardised. Analyses were by Wilcoxon rank sum tests.

Results: Study A: During pre-dilution the median FRT was 45.7 vs. 16.1 h in post-dilution CVVH (p = 0.005). The median creatinine clearance during pre-dilution was 33 vs. 45 ml/min in post-dilution (p = 0.001). Study B: During NP, median FRT was 39.5 vs. 12.3 h during HP CVVH (p = 0.045).

Conclusions: Pre-dilution CVVH results in the greatest FRT but a lower plasma creatinine clearance compared to post-dilution. Regional anticoagulation with heparin-protamine resulted in a significantly shorter FRT compared to systemic NP anticoagulation.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Anticoagulants / therapeutic use*
  • Hemofiltration* / methods
  • Heparin Antagonists / therapeutic use*
  • Humans
  • Male
  • Nadroparin / therapeutic use*
  • Protamines / therapeutic use*

Substances

  • Anticoagulants
  • Heparin Antagonists
  • Nadroparin
  • Protamines