Observation on the anticoagulant application effect of nafamostat mesilate on continuous blood purification in patients with high bleeding risk
LU Wenting
XIANG Shulin
REN Yanwen
HU Kunlin
PANG Jing
MO Li
XIONG Bin
Abstract：Objective To observe the anticoagulant application effect of nafamostat mesilate(NM)on continuous blood purification(CBP)in patients with high bleeding risk.Methods The clinical data of 34 critically ill patients with high bleeding risk who needed CBP treatment in the Department of Critical Care Medicine of the People's Hospital of Guangxi Zhuang Autonomous Region from January 2023 to March 2023 were retrospectively collected.The patients were divided into NM group(10 cases),sodium citrate group(10 cases)and low molecular weight heparin group(14 cases)according to the use of anticoagulants.The filter service life and the occurrence of clinically significant bleeding events and other adverse events were compared among the three groups.Results The filter service life was 40.00(17.00,51.00)hours,36.00(22.00,60.00)hours and 51.00(45.00,61.50)hours in the NM group,the sodium citrate group and the low molecular weight heparin group,respectively,and there was no significant difference among the three groups(H=2.096,P=0.351).During the anticoagulation process,there were no clinically significant bleeding events in the NM group,while there were 3 cases(30.00％)and 4 cases(28.57％)of clinically significant bleeding events in the sodium citrate group and the low molecular weight heparin group,respectively.The difference in the incidence of clinically significant bleeding events among the three groups was statistically significant(x2=14.171,P=0.001).Six cases of secondary thrombocytopenia occurred in the low molecular weight heparin group.The adverse reactions related to NM infusion,such as allergic reactions,hyperkalemia and agranulocytosis did not occur in the NM group.There were no adverse reactions such as accumulation of citric acid and citric acidosis in the sodium citrate group.Thromboembolic events were not observed in the patients in the three groups.Conclusion The anticoagulant effect of NM is comparable to that of sodium citrate and low molecular weight heparin,and the incidence of clinically significant bleeding events of NM is lower,so the safety of application of NM in the patients with high bleeding risk is good.
Keywords：Nafamostat mesilate(NM)Sodium citrate anticoagulantLow molecular weight heparinContinuous blood purification(CBP)Filter service lifeHemorrhage
Publication Date：2024-01-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 74-78 )