A quick reference guide to haemofiltration and renal failure March ...

MOST COMMONLY USED ANTICOAGULANT THERAPIES
* HEPARIN * CITRATE * REGIONAL HEPARINIZATION
* SALINE FLUSHES * NO ANTICOAGULATION
HEPARIN
• Heparin acts by binding to and greatly enhancing the
activity of antithrombin III, and from inhibition of a
number of coagulation factors – particularly activated
factor X. (Dorland 2003:836).
• Heparin is the most commonly used anticoagulant.
• The extracorporeal circuit is primed with heparinized saline.
Depending upon the patients own coagulation, an infusion of
heparin is delivered into the circuit prior to the
haemofilter.
• Patient coagulation levels should be taken prior to the
commencement of CRRT. At 2 hours post commencement
draw blood from the blue (venous) port and check machine
APTT. This needs to be repeated every 2hours until the
machine APTT lies between 60 – 80 seconds. Once stable
check 6 th hourly. Blood needs to be taken from both the
patient and the machine for comparison. Once coagulation is
stable within the set limits, bloods are attended 12 hourly.
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