Regional Anticoagulation with Citrate is Superior to Systemic Anticoagulation with Heparin in Critically Ill Patients Undergoing Continuous Venovenous Hemodiafiltration
DC Field | Value | Language |
---|---|---|
dc.contributor.author | Park, Joon-Sung | - |
dc.contributor.author | Kim, Gheun-Ho | - |
dc.contributor.author | Kang, Chong Myung | - |
dc.contributor.author | Lee, Chang Hwa | - |
dc.date.accessioned | 2022-07-16T21:26:21Z | - |
dc.date.available | 2022-07-16T21:26:21Z | - |
dc.date.created | 2021-05-13 | - |
dc.date.issued | 2011-03 | - |
dc.identifier.issn | 1226-3303 | - |
dc.identifier.uri | https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/168873 | - |
dc.description.abstract | Background/Aims: Short hemofilter survival and anticoagulation-related life-threatening complications are major problems in systemic anticoagulation with heparin (SAH) for continuous renal replacement therapy (CRRT). The present study examined if regional anticoagulation with citrate (RAC) using commercially available solutions can overcome the associated problems of SAH to produce economical benefits. Methods: Forty-six patients were assigned to receive SAH or RAC. We assessed the coagulation state, clinical outcomes, and adverse events. A Kaplan-Meier analysis was used to estimate hemofilter life span. The economi- cal benefit related to the prolonged hemofilter survival was examined on the basis of the average daily cost. Results: The mean age of patients was 66.5 ± 13.8 years and the majority were male (60.9%). While elective discontinuation was most common cause of early CRRT interruption in the RAC group (34.3%, p < 0.01), hemofilter clotting was most prevalent in the SAH group (82.2%, p < 0.01). The patient metabolic and electrolyte control and survival rate were not different between the two groups. When compared with the RAC group, the anticoagulation-associated bleeding was a major complication in the SAH group (15.0% vs. 61.5%, p < 0.01). Regional anticoagulated hemofilters displayed a significantly longer survival time than systemic anticoagulated hemofilters (59.5 ± 3.8 hr vs. 15.6 ± 1.3 hr, p < 0.01). Accordingly, the mean daily continuous venovenous hemodiafiltration costs in the RAC and SAH groups were $575 ± 268 and $1,209 ± 517, respectively (p < 0.01). Conclusions: RAC prolonged hemofilter survival, displaying an economical benefit without severe adverse effects. The present study therefore demonstrates that RAC, using commercially available solutions, may be advantageous over SAH as a cost-effective treatment in CRRT. | - |
dc.language | 영어 | - |
dc.language.iso | en | - |
dc.publisher | The Korean Association of Internal Medicine | - |
dc.title | Regional Anticoagulation with Citrate is Superior to Systemic Anticoagulation with Heparin in Critically Ill Patients Undergoing Continuous Venovenous Hemodiafiltration | - |
dc.type | Article | - |
dc.contributor.affiliatedAuthor | Kim, Gheun-Ho | - |
dc.contributor.affiliatedAuthor | Lee, Chang Hwa | - |
dc.identifier.doi | 10.3904/kjim.2011.26.1.68 | - |
dc.identifier.scopusid | 2-s2.0-79953280355 | - |
dc.identifier.bibliographicCitation | Korean Journal of Internal Medicine, v.26, no.1, pp.68 - 75 | - |
dc.relation.isPartOf | Korean Journal of Internal Medicine | - |
dc.citation.title | Korean Journal of Internal Medicine | - |
dc.citation.volume | 26 | - |
dc.citation.number | 1 | - |
dc.citation.startPage | 68 | - |
dc.citation.endPage | 75 | - |
dc.type.rims | ART | - |
dc.type.docType | Article | - |
dc.identifier.kciid | ART001533043 | - |
dc.description.journalClass | 1 | - |
dc.description.isOpenAccess | N | - |
dc.description.journalRegisteredClass | scopus | - |
dc.description.journalRegisteredClass | kci | - |
dc.subject.keywordPlus | acid citrate dextrose | - |
dc.subject.keywordPlus | gluconate calcium | - |
dc.subject.keywordPlus | heparin | - |
dc.subject.keywordPlus | acute kidney tubule necrosis | - |
dc.subject.keywordPlus | adult | - |
dc.subject.keywordPlus | aged | - |
dc.subject.keywordPlus | anemia | - |
dc.subject.keywordPlus | anticoagulant therapy | - |
dc.subject.keywordPlus | APACHE | - |
dc.subject.keywordPlus | article | - |
dc.subject.keywordPlus | blood clotting disorder | - |
dc.subject.keywordPlus | brain hemorrhage | - |
dc.subject.keywordPlus | clinical article | - |
dc.subject.keywordPlus | comparative effectiveness | - |
dc.subject.keywordPlus | congestive heart failure | - |
dc.subject.keywordPlus | continuous hemodiafiltration | - |
dc.subject.keywordPlus | controlled study | - |
dc.subject.keywordPlus | cost effectiveness analysis | - |
dc.subject.keywordPlus | cost of illness | - |
dc.subject.keywordPlus | critically ill patient | - |
dc.subject.keywordPlus | disease severity | - |
dc.subject.keywordPlus | drug safety | - |
dc.subject.keywordPlus | erythrocyte transfusion | - |
dc.subject.keywordPlus | female | - |
dc.subject.keywordPlus | follow up | - |
dc.subject.keywordPlus | gastrointestinal hemorrhage | - |
dc.subject.keywordPlus | hematoma | - |
dc.subject.keywordPlus | human | - |
dc.subject.keywordPlus | hypotension | - |
dc.subject.keywordPlus | lifespan | - |
dc.subject.keywordPlus | liver toxicity | - |
dc.subject.keywordPlus | lung hemorrhage | - |
dc.subject.keywordPlus | male | - |
dc.subject.keywordPlus | metabolic acidosis | - |
dc.subject.keywordPlus | metabolic alkalosis | - |
dc.subject.keywordPlus | outcome assessment | - |
dc.subject.keywordPlus | partial thromboplastin time | - |
dc.subject.keywordPlus | survival rate | - |
dc.subject.keywordPlus | survival time | - |
dc.subject.keywordPlus | thrombocyte count | - |
dc.subject.keywordPlus | thrombocyte transfusion | - |
dc.subject.keywordPlus | treatment withdrawal | - |
dc.subject.keywordPlus | Adult | - |
dc.subject.keywordPlus | Aged | - |
dc.subject.keywordPlus | Anticoagulants | - |
dc.subject.keywordPlus | Citric Acid | - |
dc.subject.keywordPlus | Critical Illness | - |
dc.subject.keywordPlus | Female | - |
dc.subject.keywordPlus | Health Care Costs | - |
dc.subject.keywordPlus | Hemodiafiltration | - |
dc.subject.keywordPlus | Heparin | - |
dc.subject.keywordPlus | Humans | - |
dc.subject.keywordPlus | Kaplan-Meier Estimate | - |
dc.subject.keywordPlus | Male | - |
dc.subject.keywordPlus | Middle Aged | - |
dc.subject.keywordAuthor | Anticoagulation | - |
dc.subject.keywordAuthor | Citric acid | - |
dc.subject.keywordAuthor | Heparin | - |
dc.subject.keywordAuthor | Renal replacement therapy | - |
dc.identifier.url | https://www.kjim.org/journal/view.php?doi=10.3904/kjim.2011.26.1.68 | - |
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.
222, Wangsimni-ro, Seongdong-gu, Seoul, 04763, Korea+82-2-2220-1365
COPYRIGHT © 2021 HANYANG UNIVERSITY.
Certain data included herein are derived from the © Web of Science of Clarivate Analytics. All rights reserved.
You may not copy or re-distribute this material in whole or in part without the prior written consent of Clarivate Analytics.