ALBUMIN PRIMING DOES NOT PROLONG HEMOFILTER LIFE

The hypothesis was tested that prepriming a hemofilter and lines with heparinized human albumin (NSA) instead of heparinized saline (NS) inc reases filter survival time. In a university affiliated intensive care unit, all patients were eligible who required continuous venovenous h emodiafiltration and who did not have pre-existing coagulopathy or con traindications to heparin. New hemofilters were randomized to priming with 2 liters NS or 1 liter NS followed by 500ml NSA. The prime was re circulated for at least 30 minutes before connection to the patient. A nticoagulation was tightly controlled, aiming for a patient activated partial thromboplastin time (APTT) of 60 seconds. Survival analysis wa s used to compare filter life. Elective discontinuations (e.g., for su rgery) were treated as censored data. A total of 91 hemofilters were u sed in 40 patients during 9 months: 45 randomized to NS, and 46 to NSA . Of these, 57 hemofilters were used until spontaneous failure, 28 NS and 29 NSA; 34 hemofilters were electively discontinued, 17 in each gr oup. Anticoagulation was identical in both groups; the mean APTT Value (+/- SE) was 58.2 seconds (+/- 3.1) for NS and 58.0 seconds (+/- 2.8) for NSA (p > 0.9 unpaired t-test). Platelet counts were very similar at 170 x 10(9) (+/- 21.8) for NS and 181 x 10(9) (+/- 23.7) for NSA (p = 0.74 unpaired t-test). There was no significant difference in the f ilter life between the two groups. For NS, median filter life was 37.8 hours (range 0.6-120); for NSA, median filter life was 45.4 hours (ra nge 2.5-109; p = 0.998 log rank). The power to detect a 50% improvemen t in filter life was > 90%. Based on this data, the use of albumin pri ming as an aid to increased hemofilter life can not be recommended.