Use of renal replacement therapy without systemic anticoagulation in patients with high risk of bleeding after cardiac and vascular surgery
Abstract
We analyzed the results of 30 procedures of renal replacement therapy (RRT) in 17 patients with the syndrome of multiorgan failure and a high risk of bleeding in early postoperative period after heart surgery performed under cardiopulmonary bypass. Thirteen procedures of hemodialysis have been carried out without the use of systemic anticoagulation, 17 procedures were performed with the use of modified extracorporeal circuit. The analysis of laboratory and clinical indices revealed a marked coagulopathy, deficiency of АТ-III, thrombocytopenia and anemia. No complications related to the methods of anticoagulation and finished by premature stopping of performance of extracorporeal circuit or by life-threatening bleeding, were revealed. The analysis of the data allows one to recommend both methods for the conduction of RRT in patients with high risk of hemorrhagic complications.
About the Authors
M. B. Yarustovsky
НЦССХ им. А.Н. Бакулева РАМН, Москва
Russian Federation
Russian Federation
N. N. Samsonova
НЦССХ им. А.Н. Бакулева РАМН, Москва
Russian Federation
Russian Federation
L. G. Balikbaeva
НЦССХ им. А.Н. Бакулева РАМН, Москва
Russian Federation
Russian Federation
S. P. Novikova
НЦССХ им. А.Н. Бакулева РАМН, Москва
Russian Federation
Russian Federation
R. G. Grigoriantz
НЦССХ им. А.Н. Бакулева РАМН, Москва
Russian Federation
Russian Federation
L. G. Klimovich
НЦССХ им. А.Н. Бакулева РАМН, Москва
Russian Federation
Russian Federation
R. A. Geptner
НЦССХ им. А.Н. Бакулева РАМН, Москва
Russian Federation
Russian Federation
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Review
For citations:
Yarustovsky M.B., Samsonova N.N., Balikbaeva L.G., Novikova S.P., Grigoriantz R.G., Klimovich L.G., Geptner R.A. Use of renal replacement therapy without systemic anticoagulation in patients with high risk of bleeding after cardiac and vascular surgery. Nephrology and Dialysis. 2004;6(2):181-188. (In Russ.)
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