Anti-PF4/heparin antibodies associated with repeated hemofiltration-filter clotting: a retrospective study
2008

Heparin Antibodies and Filter Clotting in Hemofiltration

Sample size: 28 publication Evidence: moderate

Author Information

Author(s): Sigismond Lasocki, Pascale Piednoir, Nadine Ajzenberg, Arnaud Geffroy, Abdel Benbara, Philippe Montravers

Primary Institution: Département d'Anesthésie – Réanimation Chirurgicale, APHP, CHU Bichat-Claude Bernard, Université Paris 7, Paris, France

Hypothesis

What factors are associated with positive anti-PF4/heparin antibody in cases of repeated hemofiltration-filter clotting?

Conclusion

Repeated hemofiltration-filter clotting in less than 6 hours was often associated with the presence of anti-PF4/heparin antibodies, and replacing heparin with danaparoid sodium improved hemofiltration duration and efficiency.

Supporting Evidence

  • Seven out of 28 patients tested positive for anti-PF4/heparin antibodies.
  • CVVH duration was significantly shorter in antibody-positive patients.
  • A 6-hour cutoff for CVVH session duration was the best predictor of a positive antibody test.

Takeaway

If a patient undergoing kidney treatment with a machine has their filter clog up quickly, it might be because of certain antibodies in their blood, and switching medications can help fix the problem.

Methodology

Charts of patients who had an anti-PF4/heparin antibody assay for repeated hemofiltration-filter clotting were reviewed, and antibody concentrations were measured using an enzyme-linked immunoabsorbent assay.

Potential Biases

Selection bias may exist as the study population was highly selected and did not represent all patients undergoing CVVH.

Limitations

The study was retrospective and did not assess patients without hemofiltration-filter clotting.

Participant Demographics

The study included 28 patients, with 7 testing positive for anti-PF4/heparin antibodies.

Statistical Information

P-Value

0.007

Confidence Interval

1.36 to 2.22

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1186/cc6937

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