1. [Influence of post-filter ionic calcium gradients on the longevity of CRRT local citrate anticoagulation in extracorporeal circulation].
- Author
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Wang BD, Tang QR, Niroj M, Pan HJ, and Zhang L
- Subjects
- Humans, Female, Male, Middle Aged, Retrospective Studies, Aged, Continuous Renal Replacement Therapy, Anticoagulants therapeutic use, Anticoagulants administration & dosage, Extracorporeal Circulation, Calcium, Citric Acid administration & dosage
- Abstract
Objective: To investigate the influence of different post-filter ionic calcium (Ca
2+ ) gradients (0.25-0.35 mmol/L vs>0.35-0.50 mmol/L) on the extracorporeal lifetime of local citrate anticoagulation (RCA) for continuous renal replacement therapy (CRRT). Methods: Patients who underwent CRRT with RCA at West China Hospital of Sichuan University from March 2021 to June 2022 were retrospectively selected. The basic information and the values of post-filter Ca2+ at 0, 2, and 6 hours after the start of treatment and every 6 hours thereafter were collected. The patients were divided into low concentration group (0.25-0.35 mmol/L mmol/L) and high concentration group (>0.35-0.50 mmol/L) according to the mean value of Ca2+ concentration per treatment, and propensity score matching was performed in a 1∶1 ratio to evaluate the effect of post-filter [iCa2+ ] on the duration of extracorporeal circulation in different groups. Results: A total of 232 patients (147 males and 85 females) aged (58.2±16.9) years were enrolled. There were 431 cases treated with CRRT for 12 592 h, including 317 cases (73.5%) in the low concentration group and 114 cases (26.5%) in the high concentration group. The baseline data of the two groups were matched and analyzed. Coagulation events occurred in 54.9% (62/113) and 54.0% (61/113) in the low and high concentration groups, respectively ( P =0.894). The median survival on extracorporeal circulation was 65.0 (29.0, 72.0) h and 68.0 (31.5, 72.0) h in the two groups, respectively ( P =0.805). Multivariate Cox regression analyses showed that post-filter [iCa2+ ] had no effect on extracorporeal life expectancy ( HR =0.99, 95% CI :0.55-1.79). Conclusion: During CRRT treatment with RCA, the desired anticoagulant effect can still be achieved when the post-filter [iCa2+ ] target was set to 0.25-0.50 mmol/L.- Published
- 2024
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