Abstract: Objective Hemodialysis combined with hemoperfusion is a commonly adopted clinical treatment mode, and hemoperfusion cartridge coagulation occurs frequently during treatment. Closed static heparin priming of hemoperfusion cartridge is a widely used method. This study aimed to explore the feasibility of closed dynamic circulation heparin priming for hemoperfusion cartridge and to observe its effect on cartridge coagulation, as compared those with closed static heparin priming. Methods A total of 32 patients undergoing maintenance hemodialysis in the Dialysis Unit of Peking University International Hospital were enrolled. They received hemodialysis 3 times a week, including 1 session of hemodialysis combined with hemoperfusion. A self-controlled before-and-after design was adopted. Every patient underwent 8 sessions of hemodialysis combined with hemoperfusion using closed dynamic circulation heparin priming and 8 sessions using closed static heparin priming. The heparin dosage was recorded for each session of hemodialysis combined with hemoperfusion, and the coagulation status of the hemoperfusion cartridge was evaluated. Results There was no significant difference in heparin dosage during treatment between closed dynamic circulation heparin method and closed static heparin method (58.41±7.23mg vs. 59.24±6.96mg, t=-1.730, P=0.094). The incidence of hemofilter coagulation during priming in closed dynamic circulation heparin method was lower than that in closed static heparin method (χ²=11.633, P=0.009). Specifically, the incidence of grade 2 hemofilter coagulation during priming in closed dynamic circulation heparin method was significantly lower than that in closed static heparin method (χ²=4.552, P=0.033), and the incidence of grade 3 hemofilter coagulation was also significantly lower in closed dynamic circulation heparin method (χ²=4.129, P=0.042). Conclusion In the absence of a difference in heparin dosage, closed dynamic circulation heparin priming for hemoperfusion cartridges is superior to closed static heparin priming in preventing hemoperfusion cartridge coagulation during hemodialysis combined with hemoperfusion. It is worthy of clinical promotion and application.

Key words: Closed dynamic circulating heparin method, Closed static heparin method, Hemoperfusion cartridge coagulation, Hemodialysis