2011 Volume 2 Issue 1 Pages 110-117
Continuous renal replacement therapy (CRRT) has emerged as the preferred dialysis modality for critically ill patients with acute kidney injury, particularly for those with hemodynamic instability. Anticoagulation is necessary for effective delivery of CRRT. However, it has been reported that CRRT filter and circuit survival are suddenly diminished due to unexplained coagulation. A retrospective study was conducted of CRRT cases using polysulfone synthetic hemofilters that suddenly had to be discontinued due to unexplained coagulation. In our center, three different types of polysulfone synthetic hemofilters are used: AEF-07, SH-0.8, and D-30NR. The reasons for discontinuation due to coagulation were different for each type of hemofilter. In AEF-07, arterial tube pressures were increased and in D-30R, venous tube pressures were increased. In all three types of hemofilters, decreases in filtration pressures were found. However, when one filter was replaced with a different type, no unexplained coagulation occurred. From this retrospective evaluation, it was concluded that when sudden unexplained coagulation occurred, replacement of one of the three types of polysulfone synthetic hemofilters with a different type would be the preferable solution.
