These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Hemodialysis using heparin-bound Hemophan in patients at risk of bleeding.
    Author: Lee KB, Kim B, Lee YH, Yoon SJ, Kang WH, Huh W, Kim DJ, Oh HY, Kim YG.
    Journal: Nephron Clin Pract; 2004; 97(1):c5-10. PubMed ID: 15153761.
    Abstract:
    BACKGROUND/AIMS: Since heparin can bind to Hemophan, hemodialysis using heparin-bound Hemophan (HBH-HD) could be a useful modality in patients at risk of bleeding. We designed a simplified heparin binding technique and assessed the safety and efficiency of HBH-HD. METHODS: To bind heparin to Hemophan, heparin solution (1 liter, 20 IU/ml saline) was recirculated through Hemophan (GFS plus 11, Gambro) for 1 h while the saline solution (700 ml/h) was removed. In 28 maintenance dialysis patients at risk of bleeding, we evaluated the heparin concentration (HC) and activated partial thromboplastin time (aPTT) during HBH-HD to assess the increased risk of bleeding. We compared the safety and efficiency of HBH-HD with that of routine hemodialysis with low-dose heparinization (R-HD) in a prospective cross-over study, and then analyzed the outcomes of 1,057 HBH-HD in 159 patients. RESULTS: During HBH-HD, there was a slight increase in both HC (0.15 +/- 0.03 IU/ml, p < 0.01) and aPTT (43.7 +/- 5.7 s, p < 0.01) at 15 min after the initiation of dialysis compared to predialysis levels (0.11 +/- 0.03 IU/ml and 37.5 +/- 6.3 s). However, there was no increase in HC and aPTT at 60 min, 120 min and at the end of dialysis. In a cross-over study, aPTT during dialysis was markedly lower in HBH-HD than in R-HD (p < 0.01). The Kt/V (1.22 +/- 0.31, p > 0.05) and urea clearance (136 +/- 17 ml/min, p > 0.05) of HBH-HD did not significantly differ from those of R-HD (1.29 +/- 0.57 and 136 +/- 13 ml/min). However, the loss of total blood compartment volume of the dialyzer was greater in HBH-HD (17.5 +/- 9.2%, p < 0.01) than in R-HD (2.9 +/- 1.2%). Out of 1,057 HBH-HD, 982 HBH-HD (93%) were successfully completed while 75 HBH-HD (7%) resulted in severe clotting. CONCLUSION: We conclude that the HBH-HD could minimize the bleeding risk and be an efficient HD technique in patients at high risk of bleeding. Careful observation for extracorporeal clotting is, however, required during HBH-HD.
    [Abstract] [Full Text] [Related] [New Search]