[Monitoring the efficiency of heparin anticoagulation in patients on programmed hemodialysis].

The activated partial thromboplastin time (APTT) test is widely used to monitor heparin anticoagulation. The relationship of the APTT to the activity of administered unfractionated heparin was defined in 23 patients on programmed hemodialysis, by using six APTT reagents. A calibration curve was plotted for each reagent. The heparinized and nonheparinized plasma values of APTT depended on the reagent being used. During clinical heparin therapy, an APTT-heparin concentration relationship was also defined by the used reagent. The reagents showed varying heparin sensitivity both in vitro and in vivo studies. APTT was estimated for the therapeutic application of heparin for all the reagents in the examinees. The authors consider it necessary to define an APTT-heparin concentration relationship for each reagent being used.

[Use of continuous high-volume hemofiltration in patients with sepsis and multiple organ dysfunction].

The paper gives the authors' experience in performing continuous high-volume hemofiltration in 38 patients with sepsis and multiple organ failure. The kinetics of proinflammatory cytokines and a number of plasma enzymes as markers of substances having a relatively high molecular mass was studied. The advantages of a procedure using an artificial kidney apparatus equipped with an on-line substituting fluid preparation system are described. The possibilities of correcting the parameters of homeostasis are the principles of maintenance of a hemostatic system in this group of patients during the procedure are presented. The drawbacks of this technique are also described.