AbbreviationsACTactivated clotting timeaPTTactivated partial thromboplastin timeCRRTcontinuous renal replacement therapyECCextracorporeal circulationHITheparin‐induced thrombocytopeniaIHDintermittent hemodialysisLMWHlow molecular weight heparinNMnafamostat mesilatePSpolysulfonePTprothrombin timeQbblood flow rateQddialysate flow rateQfultrafiltration rateUFHunfractionated heparinIntroductionAnticoagulation is required to prevent thrombosis when using extracorporeal circulation (ECC). Unfractionated heparin (UFH) is widely used as an anticoagulant agent for ECC in intermittent hemodialysis (IHD) in veterinary practice. In people, however, UFH is associated with adverse effects, including heparin‐induced thrombocytopenia (HIT) and increased incidence of hemorrhage (10–26%). Hemodialysis using UFH has been found to be associated with bleeding complications in 17.8% of dogs and 5.5% of all animals in a retrospective study.Systemic anticoagulation during hemodialysis increases the risk of blood loss, especially in patients with active hemorrhage, as well as in those who have experienced recent trauma or undergone surgery. There are several alternative anticoagulation methods to prevent clotting in the ECC, such as regional citrate anticoagulation, heparin/protamine regional anticoagulation, low molecular weight heparin (LMWH), and heparin‐free hemodialysis. However, these strategies also have limitations, including the potential for adverse events in patients at high risk of bleeding.Nafamostat mesilate (NM), a serine protease inhibitor originally developed to treat pancreatitis, has been used as an alternative anticoagulant in patients in Japan and South Korea at increased risk
Journal of Veterinary Emergency and Critical Care – Wiley
Published: Jan 1, 2018
Keywords: ; ; ; ; ;
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