Ion-exchange resin anticoagulation: experimental data of a novel extracorporeal regional anticoagulation technique

Introduction Regional anticoagulation has been introduced to avoid the complications of systemic anticoagulation. The most diffuse technique for regional anticoagulation is the infusion of citrate, which exerts its anticoagulative effect by chelating calcium, an essential factor of coagulation. Despite being a “regional” anticoagulation technique, a major fraction of the infused citrate reaches the patient systemic circulation and may cause toxicity. For this reason this technique can be applied only to extracorporeal blood flows lower than ~150-180 ml/min, to limit the amount of infused citrate. Ion exchange resins are polymers which contain acidic or basic functional groups able to exchange counter-ions. We have developed a regional anticoagulation technique featuring a cation exchange resin, which exchanges calcium with sodium and thus reduces plasmatic calcium levels.