Department of Nephrology, Ghent University Hospital, Gent, Belgium.
Department of Nephrology, Ghent University Hospital, Gent, Belgium.
Semin Nephrol. 2023 Nov;43(6):151474. doi: 10.1016/j.semnephrol.2023.151474. Epub 2024 Jan 24.
Maintaining patency of the extracorporeal hemodialysis (HD) circuit is a prerequisite to perform HD. Unfractionated heparin and low-molecular-weight heparins are the most used anticoagulants in maintenance HD, but their administration comes with a major trade-off of bleeding complications. This narrative review article discusses technical factors impacting on HD circuit patency, such as tubings, dialyzer membranes, priming practices, and treatment settings. Strategies for monitoring extracorporeal circuit clotting during and after treatment are also reviewed, as these are essential tools for optimizing anticoagulation.
维持体外血液透析（HD）回路的通畅是进行 HD 的前提条件。普通肝素和低分子量肝素是维持性 HD 中最常用的抗凝剂，但它们的使用带来了出血并发症的主要权衡。本文综述了影响 HD 回路通畅性的技术因素，如管道、透析器膜、预充操作和治疗设置。还回顾了治疗期间和治疗后监测体外回路凝血的策略，因为这些是优化抗凝的重要工具。
