Objective: To evaluate the safety and efficacy of enoxaparin for anticoagulation during continuous renal replacement therapy (CRRT).
Design: Six-month prospective audit on filter life, anti-Xa activity and bleeding complications among patients undergoing continuous venovenous haemodiafiltration with 1.5mg/kg enoxaparin per 24 hours. The audit was conducted between June and December 2009.
Results: Thirteen patients were included. The median overall filter survival time was 22 hours (range, 2-176 hours). Two patients experienced minor bleeding events, but there were no major bleeding events. Systemic activity of enoxaparin was demonstrated, with a significant rise in median anti-Xa activity between assays before and during filtration (0.00 [range, 0.00-0.13] v 0.31 [range, 0.07-1.26] anti-Xa U/mL; P = 0.03).
Conclusions: Enoxaparin at 1.5mg/kg/24 h appears to be effective for circuit anticoagulation in CRRT and provides significant systemic anticoagulation. Further research is required to evaluate its safety, particularly in the absence of routine anti-Xa monitoring.