1. Quality indicators in prolonged hemodialysis with regional citrate anticoagulation with the genius system: retrospective cohort of critical patients with acute kidney injury
- Author
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Jorge Alberto Menegasso Vieira, Isabel Cristina Reinheimer, Amanda Corrêa dos Santos, Fernando Kowarick Halperin, Luiza Aguirre Susin, Lia Portella Staub, Raquel Jaqueline Eder Ribeiro, Julia Braga da Silveira, Lucas Friedrich Fontoura, Diego Candido de Souza, Karen Patrícia Nunes, Vandrea Carla de Souza, Luciano da Silva Selistre, and Carlos Eduardo Poli-de-Figueiredo
- Subjects
Regional citrate anticoagulation ,SLED technique ,Hybrid renal replacement therapy ,Sustained low-efficiency dialysis ,Slow extended dialysis mode ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Background Prolonged hemodialysis (HD) is performed from 6 to 12 h and can last up to 24 h. To prevent system clotting some studies suggest that Regional Citrate Anticoagulation (RCA) use reduces bleeding rates relative to systemic heparin. However, there may be difficulties in the patient’s clinical management and completing the prescribed HD with Genius system using RCA. Objective To analyze safety Quality Indicators (IQs) and follow up on prolonged HD with 4% sodium citrate solution in a Genius® hybrid system. Methods This is a retrospective cohort conducted in an intensive care unit. Results 53 random sessions of prolonged HD with 4% sodium citrate solution of critically ill patients with AKI assessed. Evaluated safety indicators were dysnatremia and metabolic alkalosis, observed in 15% and 9.4% of the sessions, respectively. Indicators of effectiveness were system clotting which occurred in 17.3%, and the minimum completion of the prescribed HD time, which was 75.5%. Conclusion The assessment of the indicators showed that the use of RCA with a 4% sodium citrate solution in prolonged HD with the Genius system in critically ill patients with AKI can be performed in a simple, safe, and effective way.
- Published
- 2023
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