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首页> 外文期刊>Journal of clinical apheresis. >Recurring extracorporeal circuit clotting during continuous renal replacement therapy resolved after single-session therapeutic plasma exchange.
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Recurring extracorporeal circuit clotting during continuous renal replacement therapy resolved after single-session therapeutic plasma exchange.

机译：单次治疗性血浆置换后，连续性肾脏替代治疗期间反复出现的体外回路凝结得到解决。

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摘要

We report a case of a 17-year-old white male with multiple fractures and multiorgan failure who developed oliguric acute renal failure requiring continuous renal replacement therapy. Repeated clotting of the extracorporeal circuit (ECC) prevented delivery of a minimally acceptable dose of renal replacement therapy despite adequate anticoagulation and dialysis catheter exchanges. Evaluation for a primary hypercoagulable state was negative, but his fibrinogen was elevated (1,320 mg/dL, normal range: 150-400 mg/dL), which is likely induced by his severe inflammatory state. A single session of therapeutic plasma exchange (TPE) with albumin and normal saline replacement was performed with subsequent drop in fibrinogen to 615 mg/dL. No further episodes of premature ECC clotting occurred, suggesting plasma factor(s) removed may have contributed to the clinical hypercoagulable state. TPE may play an adjunctive role in select cases of recurrent ECC clotting refractory to current anticoagulation techniques.
机译：我们报告了一例17岁的白人男性，患有多处骨折和多器官功能衰竭，发展为少尿性急性肾功能衰竭，需要连续进行肾脏替代治疗。尽管进行了充分的抗凝和透析导管更换，但反复凝结体外回路（ECC）仍无法递送最低可接受剂量的肾脏替代疗法。对原发性高凝状态的评估为阴性，但其纤维蛋白原升高（1320 mg / dL，正常范围：150-400 mg / dL），这可能是由于他的严重炎症状态引起的。用白蛋白和生理盐水替代进行一次治疗性血浆交换（TPE），随后血纤蛋白原降至615 mg / dL。没有发生进一步的早发性ECC凝血事件，表明血浆因子被清除可能是导致临床高凝状态的原因。在当前抗凝技术难治的复发性ECC凝结的某些选定病例中，TPE可能起辅助作用。

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