Antithrombotiques au cours des techniques d'épuration extrarénale continue

During continuous renal replacement therapy, anticoagulation of the extracorporeal circuit is generally required for an optimal filter performance. Unfractionated heparin is still the most widely used anticoagulant. However, it presents some drawbacks: bleeding risk, heparin resistance, heparin-induced thrombocytopenia… Alternatives exist with their own disadvantages: low-molecular-weight heparin, regional citrate anticoagulation when bleeding risk is increased, recombinant hirudin, argatroban, prostacyclin, nafamostat mesilate for which indications need to be specified. The purpose of this article is to review the different strategies regarding efficacy, safety and implementation of anticoagulation during continuous renal replacement therapy.