Figure 195

Factors influencing dialysis-related thrombogenicity. One of the major determinants of the efficacy of any dialysis procedure in acute renal failure (ARF) is the ability to maintain a functioning extracorporeal circuit. Anticoagulation becomes a key component in this regard and requires a balance between an appropriate level of anticoagulation to maintain patency of the circuit and prevention of complications. Figures 19-4 and 19-5 show the mechanisms of thrombus formation in an extracorporeal circuit and the interaction of various factors in this process. (From Ward [9]; with permission.)

Heparin CRRT Anticoagulant heparin (~400|x/h)

Arterial ter I

3-way stop cock

Replacement solutions

Dialysate 1.5% dianeal

Filter

"I

Ultrafiltrate (effluent dialysate plus net ultrafiltrate)

Venous

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