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<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D;mso-fareast-language:EN-US">Bonjour,<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D;mso-fareast-language:EN-US"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D;mso-fareast-language:EN-US">Concernant la vancomycine nous l’administrons à 1 g/H ; si la dose à administrer est supérieure à 1 g on prolonge sur 1H30 voire 2H
en deuxième partie de séance.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D;mso-fareast-language:EN-US">Concernant l’HNF nous commençons par :<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D;mso-fareast-language:EN-US">- une dose de charge au branchement : ½ mg/Kg avec 10 mg = 1000U soit 3000 U pour un sujet de 60Kg, puis
<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D;mso-fareast-language:EN-US">- une dose d’entretien de 333 à 666 U/ H d’héparine sur 3H30 lors d’une dialyse de 4H sur FAV et sur toute la séance pour un cathéter.
On ne dépasse pas 999U/H.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D;mso-fareast-language:EN-US">On adapte secondairement les doses en fonction de l’état du rein et du patient.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D;mso-fareast-language:EN-US">Avec les bains au citrate la dose d’héparine a pu être baissée.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D;mso-fareast-language:EN-US"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D;mso-fareast-language:EN-US">Cordialement<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D;mso-fareast-language:EN-US"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:10.0pt;color:#1F497D">Dr B. Seigneuric<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:10.0pt;color:#1F497D">Praticien Hospitalier<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:10.0pt;color:#1F497D">Département de Néphrologie, Dialyse et Transplantation d’Organes - Unité de Dialyse Périodique<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:10.0pt;color:#1F497D">CHU Rangueil – Larrey<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:10.0pt;color:#1F497D">31059 Toulouse Cedex 9<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:10.0pt;color:#1F497D">Tel 05 67 77 18 90<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:10.0pt;color:#1F497D">Fax 05 67 77 18 88<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D;mso-fareast-language:EN-US"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:#1F497D;mso-fareast-language:EN-US"><o:p> </o:p></span></p>
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<p class="MsoNormal"><b><span style="font-size:11.0pt;font-family:"Calibri",sans-serif">De :</span></b><span style="font-size:11.0pt;font-family:"Calibri",sans-serif"> Renaliste [mailto:renaliste-bounces@nephrodial.org]
<b>De la part de</b> moussa coulibaly<br>
<b>Envoyé :</b> mardi 2 février 2016 11:16<br>
<b>À :</b> Liste des néphrologues francophones<br>
<b>Objet :</b> [Renaliste] Administration de la Vancomycine en hémodialyse et protocole d'anticoagulation chez le patient hémodialysé<o:p></o:p></span></p>
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<p class="MsoNormal"><o:p> </o:p></p>
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<p class="MsoNormal" style="background:white"><span style="font-size:9.0pt;font-family:"Helvetica",sans-serif;color:black">Bonjour,<o:p></o:p></span></p>
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<p class="MsoNormal" style="background:white"><span style="font-size:9.0pt;font-family:"Helvetica",sans-serif;color:black"><o:p> </o:p></span></p>
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<p class="MsoNormal" style="background:white"><span style="font-size:9.0pt;font-family:"Helvetica",sans-serif;color:black">J'ai deux questions concernant l'administration de la vancomycine chez le patient hémodialysé et l'héparine en continue chez les patients
hémodialysés <o:p></o:p></span></p>
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<p class="MsoNormal" style="background:white"><span style="font-size:9.0pt;font-family:"Helvetica",sans-serif;color:black">qui ont un risque hémorragique et de coagulation du circuit.
<o:p></o:p></span></p>
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<p class="MsoNormal" style="background:white"><span style="font-size:9.0pt;font-family:"Helvetica",sans-serif;color:black">J'ai eu toujours l'habitude d'administrer la Vancomycine sur la dernière heure de dialyse. Avez vous d'autres habitudes?<o:p></o:p></span></p>
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<p class="MsoNormal" style="background:white"><span style="font-size:9.0pt;font-family:"Helvetica",sans-serif;color:black">Concernant l'héparine, j'applique le protocole suivant : 25 UI/kg/h la première heure de dialyse puis 12.5 UI/kg/h la 2ème et 3ème heure
de dialyse puis j'arrête la dernière heure de dialyse. Avez vous d'autres façons de faire en dehors de l'utilisation des membranes héparinées.<o:p></o:p></span></p>
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<div id="yui_3_16_0_1_1454407169002_5416">
<p class="MsoNormal" style="background:white"><span style="font-size:9.0pt;font-family:"Helvetica",sans-serif;color:black"><o:p> </o:p></span></p>
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<p class="MsoNormal" style="background:white"><span style="font-size:9.0pt;font-family:"Helvetica",sans-serif;color:black">Merci<o:p></o:p></span></p>
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<p class="MsoNormal" style="background:white"><span style="font-size:9.0pt;font-family:"Helvetica",sans-serif;color:black"><o:p> </o:p></span></p>
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<p class="MsoNormal" style="background:white"><span style="font-size:9.0pt;font-family:"Helvetica",sans-serif;color:black">Dr COULIBALY Moussa<o:p></o:p></span></p>
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<p class="MsoNormal" style="background:white"><span style="font-size:9.0pt;font-family:"Helvetica",sans-serif;color:black">Centre Hospitalier d'Agen<o:p></o:p></span></p>
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<p class="MsoNormal" style="background:white"><span style="font-size:9.0pt;font-family:"Helvetica",sans-serif;color:black"><o:p> </o:p></span></p>
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