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Repeated premature hemofilter clotting during regional citrate anticoagulation as indicator of heparin induced thrombocytopenia

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Repeated premature hemofilter clotting during regional citrate anticoagulation as indicator of heparin induced thrombocytopenia. / Lehner, Georg Franz; Schöpf, Marion; Harler, Ulrich; Pechlaner, Christoph; Joannidis, Michael.

In: BLOOD PURIFICAT, Vol. 38, No. 2, 2014, p. 127-30.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Lehner, GF, Schöpf, M, Harler, U, Pechlaner, C & Joannidis, M 2014, 'Repeated premature hemofilter clotting during regional citrate anticoagulation as indicator of heparin induced thrombocytopenia', BLOOD PURIFICAT, vol. 38, no. 2, pp. 127-30. https://doi.org/10.1159/000366125

APA

Lehner, G. F., Schöpf, M., Harler, U., Pechlaner, C., & Joannidis, M. (2014). Repeated premature hemofilter clotting during regional citrate anticoagulation as indicator of heparin induced thrombocytopenia. BLOOD PURIFICAT, 38(2), 127-30. https://doi.org/10.1159/000366125

Vancouver

Lehner GF, Schöpf M, Harler U, Pechlaner C, Joannidis M. Repeated premature hemofilter clotting during regional citrate anticoagulation as indicator of heparin induced thrombocytopenia. BLOOD PURIFICAT. 2014;38(2):127-30. https://doi.org/10.1159/000366125

Bibtex

@article{872e0751ea1148f58e8c0c8d27c98584,
title = "Repeated premature hemofilter clotting during regional citrate anticoagulation as indicator of heparin induced thrombocytopenia",
abstract = "PURPOSE: Early clinical signs of heparin induced thrombocytopenia (HIT) are nonspecific and include a sudden drop in the number of platelets as well as formation of arterial and venous thromboses. Regional citrate anticoagulation (RCA) is increasingly used as a very effective modality to prevent filter clotting during renal replacement therapy (RRT). We report the first case where repeated premature filter clotting despite RCA indicated a manifestation of HIT.MATERIALS AND METHODS: A 71-year old woman admitted to the ICU for a compartment syndrome of the leg developed septic shock with acute kidney injury requiring continuous veno-venous hemodialysis (CVVHD). Because of unexpected and repeated premature filter clotting during CVVHD using RCA, HIT was suspected.RESULTS: The diagnosis of HIT was confirmed by the presence of IgG antibodies against heparin and platelet factor (PF) 4 complexes and six points in the 4T score. Discontinuation of heparin administration and initiation of systemic anticoagulation with danaparoid sodium resulted in the normalization of platelet count and hemofilter lifetime.CONCLUSION: RCA does not seem to be sufficient to prevent hemofilter clotting during HIT. Thus, in case of repeated premature filter clotting despite RCA, one should suspect HIT and prompt diagnostic workup as well as a switch to alternative anticoagulation.",
keywords = "Acute Kidney Injury, Aged, Anticoagulants, Chondroitin Sulfates, Citrates, Dermatan Sulfate, Equipment Failure, Female, Heparin, Heparitin Sulfate, Humans, Immunoglobulin G, Platelet Factor 4, Renal Dialysis, Shock, Septic, Thrombocytopenia, Thrombosis, Case Reports, Journal Article",
author = "Lehner, {Georg Franz} and Marion Sch{\"o}pf and Ulrich Harler and Christoph Pechlaner and Michael Joannidis",
note = "{\textcopyright} 2014 S. Karger AG, Basel.",
year = "2014",
doi = "10.1159/000366125",
language = "English",
volume = "38",
pages = "127--30",
journal = "BLOOD PURIFICAT",
issn = "0253-5068",
publisher = "S. Karger AG",
number = "2",

}

RIS

TY - JOUR

T1 - Repeated premature hemofilter clotting during regional citrate anticoagulation as indicator of heparin induced thrombocytopenia

AU - Lehner, Georg Franz

AU - Schöpf, Marion

AU - Harler, Ulrich

AU - Pechlaner, Christoph

AU - Joannidis, Michael

N1 - © 2014 S. Karger AG, Basel.

PY - 2014

Y1 - 2014

N2 - PURPOSE: Early clinical signs of heparin induced thrombocytopenia (HIT) are nonspecific and include a sudden drop in the number of platelets as well as formation of arterial and venous thromboses. Regional citrate anticoagulation (RCA) is increasingly used as a very effective modality to prevent filter clotting during renal replacement therapy (RRT). We report the first case where repeated premature filter clotting despite RCA indicated a manifestation of HIT.MATERIALS AND METHODS: A 71-year old woman admitted to the ICU for a compartment syndrome of the leg developed septic shock with acute kidney injury requiring continuous veno-venous hemodialysis (CVVHD). Because of unexpected and repeated premature filter clotting during CVVHD using RCA, HIT was suspected.RESULTS: The diagnosis of HIT was confirmed by the presence of IgG antibodies against heparin and platelet factor (PF) 4 complexes and six points in the 4T score. Discontinuation of heparin administration and initiation of systemic anticoagulation with danaparoid sodium resulted in the normalization of platelet count and hemofilter lifetime.CONCLUSION: RCA does not seem to be sufficient to prevent hemofilter clotting during HIT. Thus, in case of repeated premature filter clotting despite RCA, one should suspect HIT and prompt diagnostic workup as well as a switch to alternative anticoagulation.

AB - PURPOSE: Early clinical signs of heparin induced thrombocytopenia (HIT) are nonspecific and include a sudden drop in the number of platelets as well as formation of arterial and venous thromboses. Regional citrate anticoagulation (RCA) is increasingly used as a very effective modality to prevent filter clotting during renal replacement therapy (RRT). We report the first case where repeated premature filter clotting despite RCA indicated a manifestation of HIT.MATERIALS AND METHODS: A 71-year old woman admitted to the ICU for a compartment syndrome of the leg developed septic shock with acute kidney injury requiring continuous veno-venous hemodialysis (CVVHD). Because of unexpected and repeated premature filter clotting during CVVHD using RCA, HIT was suspected.RESULTS: The diagnosis of HIT was confirmed by the presence of IgG antibodies against heparin and platelet factor (PF) 4 complexes and six points in the 4T score. Discontinuation of heparin administration and initiation of systemic anticoagulation with danaparoid sodium resulted in the normalization of platelet count and hemofilter lifetime.CONCLUSION: RCA does not seem to be sufficient to prevent hemofilter clotting during HIT. Thus, in case of repeated premature filter clotting despite RCA, one should suspect HIT and prompt diagnostic workup as well as a switch to alternative anticoagulation.

KW - Acute Kidney Injury

KW - Aged

KW - Anticoagulants

KW - Chondroitin Sulfates

KW - Citrates

KW - Dermatan Sulfate

KW - Equipment Failure

KW - Female

KW - Heparin

KW - Heparitin Sulfate

KW - Humans

KW - Immunoglobulin G

KW - Platelet Factor 4

KW - Renal Dialysis

KW - Shock, Septic

KW - Thrombocytopenia

KW - Thrombosis

KW - Case Reports

KW - Journal Article

U2 - 10.1159/000366125

DO - 10.1159/000366125

M3 - SCORING: Journal article

C2 - 25412655

VL - 38

SP - 127

EP - 130

JO - BLOOD PURIFICAT

JF - BLOOD PURIFICAT

SN - 0253-5068

IS - 2

ER -