Safety and Efficiency of Anticoagulation Therapy during CVVH in the Patients with MODS and High-Risk Bleeding.

Objective To investigate safety and efficiency of anti-coagulation therapy in patients with high-risk of bleeding and multiple organ dysfunction syndrome (MODS) during continuous veno-venous hemofiltration (CVVH). Methods Forty patients with high-risk bleeding MODS during CVVH in our hospital were divided into heparin-free group (A group) and low-dose heparin group (B group). Blood coagulation function, platelets counts, blood urea nitrogen, serum creatinine, PaO2/FIO2 and Apache II scores in two groups were tracked before treatment and 24 h, 48 h after treatment. Filter lifespan, median ventilation time, ICU admission time and bleeding complications were observed. Results (1) There was significant difference in levels of blood urea nitrogen, serum creatinine, PaO2/FIO2 and Apache II scores at 24 h, 48 h after treatment between in low-dose heparin group and those in heparin-free group (P < 0.05). (2) Levels of activated partial thromboplastin time(APTT) , thrombin time (TT) were prolonged. Platelets count were significantly lower at 24 h after treatment than that before treatment in low-dose heparin group. Levels of APTT, TT and platelets count had no changes with prolonged time of CVVH therapy.(3) Average ventilation time, ICU admission time were obviously shorter in low-dose heparin group than that in heparin-free group. Filter lifespan was significant longer in low-dose heparin group than that in heparinfree group, (P < 0.05).(4) Bleeding in skin and mucosa was observed in 1 case in low-dose heparin group without other severe bleeding complications. Conclusion The results of monocentric study show that low dose of heparin ensure smooth operation of CVVH in patients with MODS and high-risk bleeding. The clinical application is safe and efficient. [ABSTRACT FROM AUTHOR]