Abstract
Heparin has been used as the anticoagulant for continuous blood purification (CBP: continuous hemofiltration and continuous hemodialysis) despite of its possible association with hemorrhage in the treatment of patients with multiple organ failure (MOF). Inhibitors of serine protease (ISP) were successfully developed and the incidences of bleeding complication with ISP were significantlly lower than that of heparin. To establish effective indices for optimal anticoagulation during CBP, we investigated plasma levels of thrombin/antithrombin III complex (TAT), fibrinopeptide A, fibrinopeptide Bβ15-24. FDP-D-dimerin 15 patients with MOF. Nafamostat mesilate, one of serine protease inhibitors, was used as the anticoagulant. In the patients who did not improve the MOF score of ours, levels of TAT before CBP were high and in addition, there was a tedency to get worsened during treatment in the patients whose MOF score were improved, levels of TAT before CBP were low. TAT can be a rigorous index for optimal anticoagulation of the patients with MOF during COP.
