Abstract
The study was designed to evaluate the efficacy and safety of RCA versus low-dose argatroban in CRRT of critically ill patients with high risk of bleeding, so as to provide a theoretical basis for optimizing the anticoagulation mode of CRRT in critically ill patients with high risk of bleeding. 207 patients were divided into RCA group (n = 103) and Argatroban group (n = 104). After treatment, the prothrombin time, international standardized ratio, and activated partial thromboplastin time of Argatroban group were prolonged when compared with those of RCA group (P < 0.05). Compared with Argatroban group, RCA group had significantly longer filter life span (42.1 (40.9, 46.5) h vs 41.2 (38.95, 43.2) h, P = 0.009). However, there was no significant difference between the two groups in 42-day all-cause mortality (51/103 vs 46/104, P > 0.05). The cycles of filter clotting events (GRADE 0 and GRADE Ⅲ) had significant difference between the two groups(P < 0.05). Compared with argatroban group, RCA group had slightly more bleeding complications (14/103 [13.59%] vs 8/104 [7.69%], P = 0.146). Although blood transfusion volume had no significant difference, the incidence of total adverse reactions in RCA group was significantly`higher than that in argatroban group (9.62% vs 19.42%, P = 0.045). The results showed that RCA treatment improves clinical outcome of patients at high risk of bleeding after CRRT, effectively prolongs the filter life and avoids filter clotting events. Argatroban has systemic anticoagulant effect, which has a certain impact on coagulation function, but it has better safety advantages.