Department of Intensive Care Medicine, University Hospital of the Catholic University Leuven, Herestraat 49, 3000, Leuven, Belgium.
Intensive Care Med. 2012 Nov;38(11):1818-25. doi: 10.1007/s00134-012-2633-x. Epub 2012 Jul 7.
The need for continuous anticoagulation remains a significant drawback in continuous renal replacement therapy (CRRT), especially in patients with increased bleeding risk. Polyethyleneimine treatment of the AN69 membrane (AN69ST) reduces thrombogenicity through decreased contact activation and promotion of heparin binding. The aim of this study is to evaluate whether this membrane prolongs filter survival in CRRT without anticoagulation.
A single-center, prospective, randomized, double-blind controlled trial with cross-over design comparing filter survival with the AN69ST membrane and the original AN69 membrane in 39 patients treated with continuous venovenous hemofiltraton (CVVH) without additional heparin.
Filter survival with the AN69ST membrane (n = 75) was 14.2 ± 8.2 h, which is not significantly different from the 13.3 ± 10.3 h for the original AN69 membrane (n = 76; p = 0.59). Limiting the analysis to those treatments that were interrupted for filter clotting yielded similar results: 14.4 ± 8.2 h for the AN69 ST membrane (n = 62) versus 14.1 ± 7.5 h for the original AN69 membrane (n = 56) (p = 0.93).
Compared with the original AN69 membrane, the surface-treated AN69ST membrane does not prolong filter survival during CVVH without systemic anticoagulation and with the CRRT settings used in this study.
在连续肾脏替代治疗（CRRT）中，持续抗凝仍然是一个显著的缺点，尤其是在出血风险增加的患者中。聚亚乙基亚胺处理的 AN69 膜（AN69ST）通过减少接触激活和促进肝素结合来降低血栓形成性。本研究旨在评估在无抗凝的情况下，这种膜是否能延长 CRRT 中的过滤器寿命。
一项单中心、前瞻性、随机、双盲对照试验，采用交叉设计，比较了在 39 例接受连续静脉-静脉血液滤过（CVVH）治疗的患者中，使用 AN69ST 膜和原始 AN69 膜的过滤器寿命，且均未额外使用肝素。
AN69ST 膜（n = 75）的过滤器寿命为 14.2 ± 8.2 h，与原始 AN69 膜（n = 76；p = 0.59）的 13.3 ± 10.3 h 无显著差异。将分析仅限于因过滤器堵塞而中断的治疗，得到了类似的结果：AN69 ST 膜（n = 62）的 14.4 ± 8.2 h 与原始 AN69 膜（n = 56）的 14.1 ± 7.5 h 无显著差异（p = 0.93）。
与原始 AN69 膜相比，在无全身抗凝且使用本研究中 CRRT 设置的情况下，表面处理的 AN69ST 膜不能延长 CVVH 期间的过滤器寿命。
