nidНефрология и диализNephrology and Dialysis1680-44222618-9801Российское диализное обществоnid-1959Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESОценка различных методов антикоагуляции при проведении заместительной почечной терапии у больных с высоким риском развития кровотечения после операций на сердце и сосудахAssessment of different methods of anticoagulation during renal replacement therapy in patients with high risk of bleeding after cardiac and vascular surgeryЯрустовскийМ. Б.YarustovskyM. B.noemail@neicon.ruСамсоноваН. Н.SamsonovaN. N.noemail@neicon.ruБалыкбаеваЛ. Г.BalykbaevaL. G.noemail@neicon.ruГригорьянцР. Г.GrigoriantzR. G.noemail@neicon.ruКлимовичЛ. Г.KlimovichL. G.noemail@neicon.ruГептнерР. А.GueptnerR. A.noemail@neicon.ruНЦССХ им. А.Н. Бакулева РАМН, г. МоскваRussian Federation20042706202564343452Copyright © Ярустовский М.Б., Самсонова Н.Н., Балыкбаева Л.Г., Григорьянц Р.Г., Климович Л.Г., Гептнер Р.А., 20252025Ярустовский М.Б., Самсонова Н.Н., Балыкбаева Л.Г., Григорьянц Р.Г., Климович Л.Г., Гептнер Р.А.Yarustovsky M.B., Samsonova N.N., Balykbaeva L.G., Grigoriantz R.G., Klimovich L.G., Gueptner R.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephro.ru/jour/article/view/1959

Проанализированы результаты 80 процедур заместительной почечной терапии (ЗПТ) у 35 больных с синдромом ПОН и высоким риском развития кровотечения в раннем послеоперационном периоде после кардиохирургических вмешательств в условиях искусственного кровообращения. В зависимости от исходной выраженности коагулопатии, тромбоцитопении и анемии были изучены различные методы антикоагуляции у больных трех групп: с использованием системной антикоагуляции гепарином (3-5 ед./кг/ч); низкомолекулярных гепаринов (0,5 мг/кг) и региональной антикоагуляции гепарином и протамина сульфатом (1:1). Была выявлена возможность и целесообразность применения всех трех методов антикоагуляции при проведении ЗПТ при условии дифференцированного подхода и обоснованности выбора методик у больных с высоким риском развития кровотечения после кардиохирургических операций.

We analyzed the results of 80 cases of renal replacement therapy (RRT) in 35 patients with POF syndrome and high risk of bleeding in early postoperative period after open-heart surgery. We studied different methods of coagulation depending on initial degree of coagulopathy, thrombocytopenia and anemia in three groups of patients: with the use of systemic anticoagulation with heparin (3-5 U/kg/hour), low-molecular heparins (0,5 mg/kg) and regional anticoagulation with heparin and protamine sulfate (1:1). We revealed the feasibility and the usefulness of the use of all three methods of anticoagulation during RRT on the condition of differentiated approach and justified choice of methods in patients with high risk of bleeding after cardiac surgery.

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The authors declare that there are no conflicts of interest present.