کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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3027919 | 1182993 | 2010 | 6 صفحه PDF | دانلود رایگان |
![عکس صفحه اول مقاله: A review of 122 published outcomes of danaparoid anticoagulation for intermittent haemodialysis A review of 122 published outcomes of danaparoid anticoagulation for intermittent haemodialysis](/preview/png/3027919.png)
One hundred and twenty-two case reports of treatment outcomes of danaparoid use for intermittent haemodialysis (HD) in severely ill patients with heparin intolerance (including 97 HIT patients) have been analysed. HD sessions of 4 – 6 hours were successfully conducted daily to 3 times/week for periods of up to 4 years (median 7 sessions/patient (range 1 - > 650). In these patients danaparoid use was relatively safe (4 unprovoked non-fatal major bleeds) and efficacious in protecting the circuit (95% no clotting problem) or patient (6 thromboses: 4 fatal or leading to danaparoid discontinuation).HIT diagnosis was improved if recurrent platelet count reduction with each HD and circuit/AV graft clotting were included. Alternative reasons for and very low nadirs of the platelet count undermined the usefulness of the 4T pre-test HIT predictability scores, but a positive functional serological test confirmed HIT in most patients.Deaths (15.6%) and thrombosis only occurred in HIT cases. Possible reasons are discussed. Replacing the standard intermittent pre-HD dose regimen with the therapeutic infusion regimen to provide continuous daily systemic antithrombotic protection, should further improve efficacy.ConclusionDanaparoid appears to be a useful alternative antithrombotic for patients with heparin intolerance and renal failure requiring haemodialysis.
Journal: Thrombosis Research - Volume 125, Issue 4, April 2010, Pages e171–e176