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| A comparative study of small-dose argatroban and unfractionated heparin for anticoagulation therapy in CRRT patients with high risk of bleeding |
| Xu Xiao-wen, Cao Jie, Tang Lian, Lu Jian, Shen Yi, Zhuang Zhi-wei |
| Department of Emergency,Nanjing Medical University Affiliated Suzhou Hospital, Suzhou 215002, China |
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Abstract Objective To explore the anticoagulant efficacy, security of small-dose argatroban and unfractionated heparin in continuous renal replacement therapy (CRRT) patients with high risk of bleeding. Methods There were totally 113 cases involved in this retrospective study: 86 patients in argatroban group and 27 patients in the heparin group. Before, during and after CRRT, the patient′s coagulation indexes, the filter tube clotting events, bleeding events and other laboratory indicators were collected. Results ①Efficacy analysis: In argatroban group, APTT during CRRT were prolonged when compared to that before CRRT,and had statistical difference (P=0.000), but APTT after CRRT had no statistical difference when compared to before CRRT. Compared to argatroban group, APTT after CRRT in heparin group were more prolonged (P= 0.016). ②The filter tube clotting events in argatroban and heparin groups were 11.9% and 8.4%, and had no statistical differences (P= 0.350). The range of creatinine decrease in argatroban group was higher than that in the heparin group, and had statistical difference (P= 0.012). ③Safety analysis: The rates of bleeding events were 7.0% and 22.2% in the group of argatroban and heparin group, and had statistical difference (P= 0.025). No severe bleeding events were observed in each group. Before and after CRRT, platelet and hemoglobin had no statistical difference. Conclusion Compared with heparin, argatroban has a good anticoagulant effect and less bleeding events, the coagulant function can be recovered quickly after CRRT. Argatroban is a better choice for critically ill patients with high risk of bleeding in CRRT.
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Received: 02 August 2017
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Corresponding Authors:
Zhuang Zhi-wei, E-mail: zzw680810@163.com
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