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Objective To observe the influences of regional citrate or systemic heparin anticoagulation on acid-base balance, coagulation, electrolytes, serum creatinine, alanine aminotransferase (ALT) and cardiac index (CI) during continuous renal replacement therapy (CRRT) rewarming in accidental hypothermia dogs. Methods Nineteen adult beagles were given abdominal trauma coupled with deep hypothermia [(28±0.5)℃] induced by seawater immersion for establishing animal model of trauma. According to rewarming ways, the animal models were randomly divided into three groups, comparison group (warm bath rewarming, n=5), CRRT rewarming-systemic heparin anticoagulation group (heparin anticoagulation group, n=7) and CRRT rewarming-regional citrate anticoagulation group (citrate anticoagulation group, n=7). During the rewarming routine blood examination was performed, and blood chemistry, coagulation function, blood gas and hemodynamic status were assayed, at the same time the mortality was recorded. Results During the rewarming, the mortality was 14.3% (1/7) in heparin anticoagulation group, 40.0% (2/5) in warm bath group and 0 in regional citrate anticoagulation group. Blood temperature in creased to 38℃, the heparin anticoagulation group showed a significant decrease of platelet compared with citrate anticoagulation group and comparison group (P0.05). Conclusions CRRT plus warm bath rewarming have better effect on improving metabolic acidosis than warm bath rewarming alone in accidental hypothermia dogs. In comparison with systemic heparin anticoagulation, regional citrate anticoagulation has smaller influences on coagulation system and platelet when CRRT rewarming performed in accidental hypothermia dogs. DOI: 10.11855/j.issn.0577-7402.2016.10.05