Renal Replacement Therapy
Conditions
Brief summary
The investigators will evaluate the impact of dialysis modality (intermittent hemodialysis or continuous renal replacement therapy) in coagulation and platelet function in critically ill patients
Detailed description
An prospective observational study will be conducted to confirm the impact of two dialysis modalitites on coagulation and platelet function in critically ill patients requiring renal replacement therapy using laboratory test, Multiplate and ROTEM.
Interventions
PROCEDUREdialysis mode
intermittent hemodialysis or continuous renal replacement therapy
Sponsors
Seoul National University Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
19 Years to No maximum
Healthy volunteers
No
Inclusion criteria
• Critically ill adult patients in surgical intensive care unit who require renal replacement therapy
Exclusion criteria
* Patients treated with anti-coagulation therapy due to thrombosis/embolism * Patients who take anti-platelet drug due to cardiac or cerebrovascular diseased * Patients treated with pharmacological prophylaxis of deep vein thrombosis * Patients who received blood products within 24 hours of dialysis initiation * Patients who do not want life-sustaining care including renal replacement therapy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| clotting time (CT) in EXTEM in rotational thromboelastometry (ROTEM) | before and after applying each mode of dialysis (4 hours in intermittent hemodialysis and 48 hours in continuous renal replacement therapy | the difference of changes in CT in EXTEM of ROTEM (seconds) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Multiplate® platelet function analysis area under curve unit | before and after applying each mode of dialysis (4 hours in intermittent hemodialysis and 48 hours in continuous renal replacement therapy | the difference of platelet function using Multiplate® |
| clot formation time (CFT) in EXTEM | before and after applying each mode of dialysis (4 hours in intermittent hemodialysis and 48 hours in continuous renal replacement therapy | the difference of CFT in EXTEM using ROTEM (seconds) |
| Amplitude 10 minutes after CT (A10) in EXTEM | before and after applying each mode of dialysis (4 hours in intermittent hemodialysis and 48 hours in continuous renal replacement therapy | the difference of A10 in EXTEM using ROTEM (mm) |
| α-angle in EXTEM | before and after applying each mode of dialysis (4 hours in intermittent hemodialysis and 48 hours in continuous renal replacement therapy | the difference of α-angle in EXTEM using ROTEM (º) |
| Maximal clot firmness (MCF) in EXTEM | before and after applying each mode of dialysis (4 hours in intermittent hemodialysis and 48 hours in continuous renal replacement therapy | the difference of MCF in EXTEM using ROTEM (mm) |
| prothrombin time | before and after applying each mode of dialysis (4 hours in intermittent hemodialysis and 48 hours in continuous renal replacement therapy | the difference of prothrombin time (seconds) |
| activated partial thromboplastin time | before and after applying each mode of dialysis (4 hours in intermittent hemodialysis and 48 hours in continuous renal replacement therapy | the difference of activated partial thromboplastin time (seconds) |
| Protein S | before and after applying each mode of dialysis (4 hours in intermittent hemodialysis and 48 hours in continuous renal replacement therapy | the difference of Protein S |
| fibrinogen | before and after applying each mode of dialysis (4 hours in intermittent hemodialysis and 48 hours in continuous renal replacement therapy | the difference of fibrinogen |
| D-dimer | before and after applying each mode of dialysis (4 hours in intermittent hemodialysis and 48 hours in continuous renal replacement therapy | the difference of D-dimer |
| platelet count | before and after applying each mode of dialysis (4 hours in intermittent hemodialysis and 48 hours in continuous renal replacement therapy | the difference of platelet count |
| the amount of blood transfusion | 24 hours | the amount of blood transfusion for 24 hours after taking second blood sample |
| hemodynamic changes | 24 hours | changes of mean arterial pressure \> 20 %, increased vasopressor/inotropics |
| changes of characteristics or amount of drainage | 24 hours | changes of characteristics or amount of drainage |
| Protein C | before and after applying each mode of dialysis (4 hours in intermittent hemodialysis and 48 hours in continuous renal replacement therapy | the difference of Protein C |
Other
| Measure | Time frame | Description |
|---|---|---|
| complication related to bleeding | 24 hours | gastrointestinal bleeding-hematochezia/melena, intra-abdominal bleeding, airway bleeding |
Countries
South Korea
Outcome results
None listed