Selected article for: "continuous CRRT renal replacement therapy and renal replacement therapy"
Author: Seshadri, Madhav; Ahamed, Jasimuddin; Laurence, Jeffrey
Title: Intervention in COVID-19 linked hypercoaguable states characterized by circuit thrombosis utilizing a direct thrombin inhibitor
  • Cord-id: mikyyyru
  • Document date: 2020_9_8
    • ID: mikyyyru
    Snippet: • Complex coagulopathies are a feature of severe COVID-19. Circuit thrombosis complicates continuous renal replacement therapy (CRRT) and ECMO, and has a high incidence despite standard heparin-based anticoagulation regimens. • We describe 5 cases of CRRT circuit thrombosis despite use of prophylactic or therapeutic doses of unfractionated or low molecular weight heparin. All 5 were resolved on initiation of a direct thrombin inhibitor, argatroban. • Changes in fibrinogen levels better ref
    Document: • Complex coagulopathies are a feature of severe COVID-19. Circuit thrombosis complicates continuous renal replacement therapy (CRRT) and ECMO, and has a high incidence despite standard heparin-based anticoagulation regimens. • We describe 5 cases of CRRT circuit thrombosis despite use of prophylactic or therapeutic doses of unfractionated or low molecular weight heparin. All 5 were resolved on initiation of a direct thrombin inhibitor, argatroban. • Changes in fibrinogen levels better reflected response to anticoagulation than did extent of changes in d-dimer levels. • Discussion as to potential reasons for better response to a direct thrombin inhibitor in a disorder such as COVID-19, complicated by high fibrinogen levels and decreased anti-0thrombin III levels is offered.

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