Dose adjustment of heparin in the hemodialysis after vascular intervention
スポンサーリンク
概要
- 論文の詳細を見る
In hemodialysis patients, hemodialysis is frequently performed just after coronary angiography during angioplasty. However, the dose of heparin used in the intervention varies widely, making it difficult to perform hemodialysis safely. Therefore, we developed guidelines for heparin dose after such an intervention based on measurement of ACT (Activated Coagulation Time). We measured ACT at the beginning of hemodialysis, and the dose of heparin was selected based on the ACT values. When ACT is more than 200 sec, heparin infusion is discontinued. When ACT ranges from 150 to 200 sec, the dose of heparin is half of that used during regular hemodialysis, and when ACT is less than 150 sec, the dose of heparin is the same as that in regular hemodialysis. In this paper, we investigated the effectiveness of these guidelines. The coagulation time of ACT were measured before, 2 hours after the start and at the end of hemodialysis in 50 patients undergoing regular hemodialysis and 50 patients undergoing post-intervention hemodialysis. Just before the start of hemodialysis, the ACT of post-intervention patients was markedly prolonged to 173.6±65.1 sec, compared to 103.6±14.2 sec in those undergoing regular HD. Two hours after the start of HD, ACT was 150.5±39.4 sec in post-intervention patients, and 127.5±22.8 sec in those undergoing regular HD. At the end of HD, ACT was 133.7±25.0 in post-intervention patients and 119.3±18.8 in those undergoing regular HD, which was not significantly different. Therefore, we concluded that heparin dose adjustment guidelines are satisfactory.
- 社団法人 日本透析医学会の論文
社団法人 日本透析医学会 | 論文
- 4．血液浄化療法の生体適合性と腎性貧血
- PD-HD併用療法においての腎機能保護の可能性 : 第51回日本透析医学会ワークショップより
- 腹部大動脈人工血管の仮性動脈瘤破裂，および右大腿回旋動脈の仮性動脈瘤破裂をきたした血液透析患者の1例
- 5．透析患者のインスリン抵抗性と腎性貧血
- 摘出腫瘤の病理組織標本所見より頸椎腫瘍状石灰沈着症 (cervical tumoral calcinosis) と診断し得た維持透析患者の1例