Audit of safety and quality of the use of enoxaparin for anticoagulation in continuous renal replacement therapy

To evaluate the safety and efficacy of enoxaparin for anticoagulation during continuous renal replacement therapy (CRRT).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.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).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.