Albumin Loss and Citrate Load in Pre-Dilution High Cut-Off-CVVHDF with Regional Citrate (18 mmol/L) and High Cut-Off CVVHD with Systemic Heparin: An in vitro Study

2018 ◽  
Vol 46 (3) ◽  
pp. 205-213
Author(s):  
Gianluca Villa ◽  
Mauro Neri ◽  
Silvia De Rosa ◽  
Sara Samoni ◽  
Cosimo Chelazzi ◽  
...  
Keyword(s):  
In Vitro Study ◽  
Vitro Study ◽  
Extracorporeal Circuit ◽  
Citrate Solution ◽  
Citrate Anticoagulation ◽  
Single Pass ◽  
Metabolic Load ◽  
Heparin Anticoagulation ◽  
Regional Anticoagulation

Background: Convective therapies with high cut-off membranes (HCO) are usually not recommended because of theoretical excessive albumin loss. The aim of this in vitro study is to demonstrate the noninferior safety of pre-dilution hemodiafiltration with HCO (HCO-CVVHDF) with isotonic citrate anticoagulation (18 mmol/L) with respect to heparin anticoagulated hemodialysis with HCO (HCO-CVVHD) in terms of albumin removal and citrate load. Method: ­Albumin removal was compared in vitro between 3 pre-­dilution-HCO-CVVHDF with citrate anticoagulation and 3 ­HCO-CVVHD with heparin anticoagulation during 30-min single-pass and 180-min recirculation phases. Results: Considering concentrations and flows in the extracorporeal circuit, the transmembrane albumin removal was 2.06 (1.51; 2.09) g and 2.09 (1.9; 2.8) g respectively for HCO-CVVHDF and HCO-CVVHD, during the single-pass phase; 2.8 (2.67; 4.59) g and 2.54 (2.35; 4.67) g, respectively, for HCO-CVVHDF and HCO-CVVHD during the recirculation phase. Based on the citrate saturation coefficients, a citrate metabolic load of 8.86 mmol/h has been calculated for HCO-CVVHDF. Conclusion: HCO-CVVHDF performed with regional anticoagulation with 18 mmol/L citrate solution does not induce higher ­albumin transmembrane removal compared to HCO-CVVHD.

Heparinase I (Neutralase) Reversal of Systemic Anticoagulation

1996 ◽  
Vol 85 (2) ◽  
pp. 339-346 ◽  
Author(s):  
Luis G. Michelsen ◽  
Mutsuhito Kikura ◽  
Jerrold H. Levy ◽  
Mi Kyoung Lee ◽  
King C. Lee ◽  
...  
Keyword(s):  
Adverse Reactions ◽  
In Vitro Study ◽  
Vitro Study ◽  
Heparin Anticoagulation ◽  
Extracorporeal Circuits ◽  
Anesthetized Dogs ◽  
Heparinase I ◽  
Canine Study

Background Protamine causes multiple adverse reactions. Heparinase I, a specific enzyme that inactivates heparin, is a possible alternative to protamine. In this study, the authors examined the efficacy of heparinase I to reverse heparin-induced anticoagulation in vitro and compared heparinase I to protamine as an antagonist of heparin-induced anticoagulation in dogs. Methods In the in vitro study, blood was obtained from the extracorporeal circuits of 12 patients, and activated clotting times were determined after adding different concentrations of heparinase I. In the in vivo study, 24 anesthetized dogs received 300 units/kg heparin injected intravenously for 5 s, then 10 min later, 3.9 mg/kg protamine, 5-41 micrograms/kg heparinase I, or the vehicle (n = 4/group) were administered intravenously, and activated clotting times and hemodynamics were measured. Results In the in vitro study, heparin concentrations of 3.3 +/- 1.0 (mean +/- SD) units/ml (approximately 0.033 mg/ml; n = 12) were reversed in the blood of patients by heparinase I at concentrations > 0.490 microgram/ml. In the canine study, heparinase at all doses studied and protamine effectively reversed the anticoagulating effects of heparin within 10 min of administration. Protamine produced adverse hemodynamic effects, whereas heparinase or its vehicle produced no significant change in arterial pressure. Conclusion Both heparinase I and protamine effectively reversed heparin anticoagulation. However, as opposed to protamine, heparinase I did not produce any significant hemodynamic changes when given as a bolus to dogs.

scholarly journals A clinical and in vitro study on the possible interaction of intravenous nitrates with heparin anticoagulation

1994 ◽  
Vol 17 (12) ◽  
pp. 658-661 ◽  
Author(s):  
Maurice Pye ◽  
Keith G. Oldroyd ◽  
Ian Hutton ◽  
Stuart M. Cobbe ◽  
James A. Conkie
Keyword(s):  
In Vitro Study ◽  
Vitro Study ◽  
Heparin Anticoagulation

In vitro study of the interaction between human gut microbiota and herbal extracts using willow bark extract as an example

Planta Medica ◽  
2016 ◽  
Vol 81 (S 01) ◽  
pp. S1-S381
Author(s):  
EM Pferschy-Wenzig ◽  
K Koskinen ◽  
C Moissl-Eichinger ◽  
R Bauer
Keyword(s):  
Gut Microbiota ◽  
In Vitro Study ◽  
Vitro Study ◽  
Bark Extract ◽  
Herbal Extracts ◽  
Human Gut ◽  
Human Gut Microbiota ◽  
Willow Bark

Evaluation of the Release Behavior of the Dexamethasone Embedded in Polycarbonate Polyurethane Membranes: An In Vitro Study

2003 ◽  
Vol 48 (1) ◽  
pp. 7 ◽  
Author(s):  
Dong Hyun Kim ◽  
Sung Gwon Kang ◽  
Sang Soo Park ◽  
Don Haeng Lee ◽  
Gyu Baek Lee ◽  
...  
Keyword(s):  
In Vitro Study ◽  
Vitro Study ◽  
Release Behavior ◽  
Polyurethane Membranes
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