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Simplified citrate anticoagulation for CRRT without calcium replacement.

In English

Författare

Summary, in English

Since 2012 citrate anticoagulation is the recommended anticoagulation strategy for CRRT. The main drawback using citrate compared with heparin as anticoagulant is the need for calcium replacement and the rigorous control of calcium levels. This study investigated the possibility to achieve anticoagulation while eliminating the need for calcium replacement. This was successfully achieved by including citrate and calcium in all CRRT solutions. Thereby the total calcium concentration was kept constant throughout the extracorporeal circuit while the ionized calcium was kept at levels low enough to avoid clotting. Being a completely new concept, only five patients with acute renal failure were included in a short, prospective, intensely supervised non-randomized pilot study.Systemic electrolyte levels and acid-base parameters were stable and remained within physiological levels. Ionized calcium levels declined slightly initially, but stabilized at 1.1 mmol/l. Plasma citrate concentrations stabilized at around 0.6 mmol/l. All post-filter ionized calcium levels were <0.5 mmol/l, i.e. an anticoagulation effect was reached. All filter pressures were normal indicating no clotting problems, and no visible clotting was observed. No calcium replacement was needed.This pilot study suggests that it is possible to perform regional citrate anticoagulation without the need for separate calcium infusion during CRRT.

Publiceringsår

2015

Språk

Engelska

Sidor

437-442

Publikation/Tidskrift/Serie

ASAIO Journal

Volym

61

Issue

4

Dokumenttyp

Artikel i tidskrift

Förlag

Amercian Society of Artificial Internal Organs

Ämne

  • Anesthesiology and Intensive Care
  • Urology and Nephrology
  • Microbiology in the medical area

Status

Published

Forskningsgrupp

  • Clinical Microbiology, Malmö

ISBN/ISSN/Övrigt

  • ISSN: 1538-943X