Objective: To explore the ideal anticoagulation dose of argatroban during high volume hemofiltration.
Methods: Crossover study was designed and 10 patients were treated with high volume hemofiltration for 3 times. Three argatroban anticoagulation regimens were instituted accordingly. The dose of argatroban was 0.02 mg kg (-1) h(-1) in regimen A, 0.04 mg kg(-1) h(-1) in regimen B, and 0.06 mg kg(-1) h(-1) in regimen C. Coagulation parameters of patients on 1, 4 and 8 hours after the beginning of treatment were detected. Coagulation degree of the filter at the end of treatment and bleeding event during 12 hours after the end of treatment were observed.
Results: The value of activated partial thromboplastin time (APTT), thrombin time (TT) and international normalized ratio (INR) after treatment were significantly higher than those before treatment (all P<0.05). APTT during treatment showed no difference among three regimens. TT and INR of 1 hour after beginning of treatment in patients of regimen C and B were longer than those in regimen A (all P<0.05), there was no bleeding event in three regimens. Filter coagulation in regimen C at the end of treatment was more serious than other two regimens.
Conclusion: Argatroban dose in the range of 0.02-0.06 mg kg(-1) h(-1) is safe for anti-coagulation in high volume hemofiltration.