Evidence map›Paper›PMID 38991509›Full record

ArticleBlood purification2024

A Comparison of the Anticoagulation Efficacy and Safety of Epoprostenol to Heparin and Citrate in Children Receiving Continuous Renal Replacement Therapy.

Esha Sondhi, Martha Stewart, Jenna Harper, Leslie Konyk, Coleen McSteen, Kelli L Crowley, Nahmah Kim-Campbell, Anthony Fabio, Dana Y Fuhrman

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Blood purification, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Neonatal continuous kidney replacement therapy.Pediatric nephrology (Berlin, Germany) · 2026
    Review
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Esha SondhiDivision of Pediatric Critical Care, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Martha StewartDepartment of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Jenna HarperDivision of Pediatric Critical Care, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Leslie KonykDivision of Pediatric Critical Care, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Coleen McSteenDivision of Pediatric Critical Care, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Kelli L CrowleyDepartment of Pharmacy, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Nahmah Kim-CampbellDivision of Pediatric Critical Care, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Anthony FabioDepartment of Epidemiology, Epidemiology Data Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Dana Y FuhrmanDivision of Pediatric Critical Care, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Funding

Renal Fitness in Young Adults with Congenital Heart DiseaseK23DK116973 · NIDDK · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI FUHRMAN, DANA YOUNG · 2019 to 2023
$1.2M
Mechanisms of Cell-Free Plasma Hemoglobin-Mediated Renal Injury after Cardiopulmonary BypassK23HD100553 · NICHD · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI KIM-CAMPBELL, NAHMAH · 2020 to 2023
$639k
NICHD NIH HHS K23 HD100553NIDDK NIH HHS K23 DK116973
6 · The paper itself

Abstract

introductionAnticoagulants are used in continuous renal replacement therapy (CRRT) to prolong filter life. There are no prior investigations directly comparing epoprostenol to more commonly used forms of anticoagulation in children. Therefore, the primary aim of this study was to assess the efficacy and safety of epoprostenol as compared to heparin and citrate anticoagulation in a pediatric cohort.

methodsWe performed a retrospective analysis of all patients <18 years of age admitted to an academic quaternary care children's hospital from 2017-2022 who received epoprostenol, heparin, or citrate exclusively for CRRT anticoagulation. Efficacy was evaluated by comparing the hours to the first unintended filter change and the ratio of filters used to CRRT days. Safety was assessed by evaluating changes in platelet count and vasoactive-ionotropic score (VIS).

resultsOf 101 patients, 44 received epoprostenol (43.6%), 38 received heparin (37.6%), and 19 received citrate (18.8%). The first filter change was more commonly planned in patients receiving anticoagulation with epoprostenol (43%) as compared to citrate (11%) or heparin (29%) (p = 0.034). Of those patients where the first filter change was unintended (n = 33), there were greater median hours until the filter was replaced in those receiving epoprostenol (29) when compared to citrate (21) (p = 0.002) or heparin (18) (p = 0.003). There was a smaller median ratio of filters used to days on therapy in the patients that received epoprostenol (0.53) when compared to citrate (1) (p = 0.003) or heparin (0.75) (p = 0.001). For those receiving epoprostenol, there was no significant decrease in platelet count when comparing values prior to CRRT initiation through 7 days of therapy. There was no significant difference in VIS when comparing values prior to CRRT initiation through the first 2 days of CRRT.

conclusionsEpoprostenol-based anticoagulation is effective when compared to other anticoagulation strategies used in pediatric CRRT with a favorable side effect profile.

Indexed as

AnticoagulantsCitric AcidContinuous Renal Replacement TherapyEpoprostenolHeparinAdolescentBlood CoagulationChildChild, PreschoolFemaleHumansInfantMaleRetrospective StudiesAnticoagulantsCitric AcidEpoprostenolHeparinChildrenContinuous renal replacement therapyEpoprostenolPediatricsProstacyclin

Identifiers

PMID38991509
PMCPMC11444869

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.