- Dedication
- Preface
- Contributors
- Chapter 1 The Critically Ill Patient with Acute Kidney Injury
- Chapter 2 History and Rationale for Continuous Renal Replacement Therapy
- Chapter 3 Nomenclature for Renal Replacement Therapy in Acute Kidney Injury
- Chapter 4 Basic Principles of Solute Transport
- Chapter 5 Principles of Fluid Management in the Intensive Care Unit
- Chapter 6 Indications, Timing, and Patient Selection
- Chapter 7 Biomarkers for Initiation of Renal Replacement Therapy
- Chapter 8 Extended Indications
- Chapter 9 Dose Adequacy and Assessment
- Chapter 10 Acid–Base and Electrolyte Disorders
- Chapter 11 Choosing a Renal Replacement Therapy in Acute Kidney Injury
- Chapter 12 Vascular Access for Continuous Renal Replacement Therapy
- Chapter 13 The Circuit and the Prescription
- Chapter 14 The Membrane
- Chapter 15 Fluids for Continuous Renal Replacement Therapy
- Chapter 16 Alarms and Troubleshooting
- Chapter 17 Nonanticoagulation Strategies to Optimize Circuit Function in RRT
- Chapter 18 Anticoagulation
- Chapter 19 Regional Citrate Anticoagulation
- Chapter 20 Drug Dosing in Continuous Renal Replacement Therapy
- Chapter 21 Renal Replacement Therapy in Children
- Chapter 22 Therapeutic Plasma Exchange in Critical Care Medicine
- Chapter 23 MARS
- Chapter 24 Sorbents
- Chapter 25 Hybrid Therapies
- Chapter 26 The ICU Environment
- Chapter 27 Patient Care Quality and Teamwork
- Chapter 28 Organizational Aspects
- Chapter 29 Documentation, Billing, and Reimbursement for Continuous Renal Replacement Therapy
- Chapter 30 Machines for Continuous Renal Replacement Therapy
- Chapter 31 Quality Improvement for Continuous Renal Replacement Therapies
- Chapter 32 Educational Resources
- Glossary
- Index
(p. 145) Anticoagulation
- Chapter:
- (p. 145) Anticoagulation
- Author(s):
Rinaldo Bellomo
and Ian Baldwin
- DOI:
- 10.1093/med/9780190225537.003.0018
Continuous treatment suggests extracorporeal blood flow without clotting. This is not a realistic aim. However drugs blocking normal coagulation pathways can prevent or delay clotting such that sufficient treatment time is achieved, and importantly patient blood is returned before complete circuit obstruction. Anticoagulation primarily refers to the use of agents that prevent blood from clotting after contact with the plastic and artificial surfaces in the extracorporeal circuit (EC). Heparin is most commonly used as an anticoagulant for RRT by blocking factor Xa and thrombin. Citrate is also routinely used to prevent clotting by chelating calcium and preventing its action as a co-factor. Administration of anticoagulant drugs during RRT requires specific knowledge and the application of monitoring protocols to ensure safety and effectiveness. This chapter provides a brief clinical guide to such treatment.
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- Dedication
- Preface
- Contributors
- Chapter 1 The Critically Ill Patient with Acute Kidney Injury
- Chapter 2 History and Rationale for Continuous Renal Replacement Therapy
- Chapter 3 Nomenclature for Renal Replacement Therapy in Acute Kidney Injury
- Chapter 4 Basic Principles of Solute Transport
- Chapter 5 Principles of Fluid Management in the Intensive Care Unit
- Chapter 6 Indications, Timing, and Patient Selection
- Chapter 7 Biomarkers for Initiation of Renal Replacement Therapy
- Chapter 8 Extended Indications
- Chapter 9 Dose Adequacy and Assessment
- Chapter 10 Acid–Base and Electrolyte Disorders
- Chapter 11 Choosing a Renal Replacement Therapy in Acute Kidney Injury
- Chapter 12 Vascular Access for Continuous Renal Replacement Therapy
- Chapter 13 The Circuit and the Prescription
- Chapter 14 The Membrane
- Chapter 15 Fluids for Continuous Renal Replacement Therapy
- Chapter 16 Alarms and Troubleshooting
- Chapter 17 Nonanticoagulation Strategies to Optimize Circuit Function in RRT
- Chapter 18 Anticoagulation
- Chapter 19 Regional Citrate Anticoagulation
- Chapter 20 Drug Dosing in Continuous Renal Replacement Therapy
- Chapter 21 Renal Replacement Therapy in Children
- Chapter 22 Therapeutic Plasma Exchange in Critical Care Medicine
- Chapter 23 MARS
- Chapter 24 Sorbents
- Chapter 25 Hybrid Therapies
- Chapter 26 The ICU Environment
- Chapter 27 Patient Care Quality and Teamwork
- Chapter 28 Organizational Aspects
- Chapter 29 Documentation, Billing, and Reimbursement for Continuous Renal Replacement Therapy
- Chapter 30 Machines for Continuous Renal Replacement Therapy
- Chapter 31 Quality Improvement for Continuous Renal Replacement Therapies
- Chapter 32 Educational Resources
- Glossary
- Index