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EVALUATION OF ENOXAPARIN'S ANTI-COAGULATION RESULTS IN INTERMITTENT HEMODIALYSIS AT THE INTENSIVE CARE UNIT DEPARTMENT OF THANH NHAN HOSPITAL
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Abstract
Background: To evaluate the anticoagulation results of Enoxaparine filter membrane in intermittent hemodialysis at the Intensive Care Unit of Thanh Nhan Hospital from March 2025 to September 2025. Method: Prospective intervention study on 41 patients admitted to the study with indications for intermittent hemodialysis at the Intensive Care Unit of Thanh Nhan Hospital from March 2025 to September 2025. Results: The study group had 41 patients, including 25 men (61%), 16 women (39%), patients in the group mainly had indications for intermittent hemodialysis such as acute pulmonary edema in patients with renal failure (51%), metabolic acidosis not responding to internal medicine (24%), uremic syndrome (12%)... Average age 65.3 ± 16.6, men: 66.4 ± 18.5, women: 54.2 ± 12.8, p=0.451. Change in Urea before - after dialysis: 25.7 ± 12.1 vs 15.5 ± 8.1, p=0.0318; Creatinine change before - after filtration: 361.12 ± 85.12 vs 202.8 ± 22.2, p=0.0273; Potassium change before - after filtration: 5.6 ± 1.5 vs 3.6 ± 0.4, p=0.0392. Platelet change before - after filtration has no statistical significance p> 0.05. TMP and Filter drop indexes gradually increase over IHD time. This is a normal development during IHD but TMP is still within the set alarm limit. 25/130 IHD times (19.2%) have anti Xa < 0.4 IU/ml but only 2 cases have high TMP membrane obstruction that cannot be treated. Before enoxaparin injection: 128/135 IHD times (94.8%) have anti Xa < 0.4 IU/ml; 1 hour after enoxaparin injection: 25/130 IHD sessions (19.2%) had anti-Xa < 0.4 IU/ml. 80/130 IHD sessions (61.6%) had anti-Xa 0.4 - 1.2 IU/ml. 25/130 IHD sessions (19.2%) had anti-Xa > 1.2 IU/ml; after IHD: 4/128 IHD sessions (3.1%) had anti-Xa > 1.2 IU/ml, which was beyond the desired anticoagulant effect, but no bleeding or blood loss was observed. Conclusion: The effectiveness of membrane anticoagulation when using the enoxaparin regimen in HT replacement reached 98.5% (133/135).
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Keywords
intermittent hemodialysis, catheter, renal failure, acute pulmonary edema, poisoning, uremia
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