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Regional citrate anticoagulation in critically ill patients treated with plasma filtration and adsorption.
- Source :
-
Blood purification [Blood Purif] 2004; Vol. 22 (3), pp. 313-9. - Publication Year :
- 2004
-
Abstract
- Background: In high-risk bleeding conditions conventional systemic anticoagulation with heparin is a contraindication to renal replacement therapy. We evaluate the feasibility and safety of regional citrate anticoagulation in high-risk bleeding conditions during coupled plasma filtration adsorption (CPFA).<br />Methods: Thirteen critically ill patients (9 severely burned, 4 polytraumas) with septic shock and acute renal failure treated with CPFA-CVVHD by using bicarbonate-based solutions (heparin-CPFA group, 58 sessions) or with CPFA-CVVHF using citrate (citrate-CPFA group, 36 sessions).<br />Results: Plasma flow and used cartridges showed no differences between the citrate-CPFA and heparin-CPFA groups, while lost clotted cartridges were significantly lower in the citrate-CPFA group. Blood ionized calcium (iCa2+), Ca2+ infusion, pH and bicarbonates remained constant during citrate-CPFA, with no difference between pre- and post-cartridge plasma citrate. A significant positive correlation between iCa2+ in blood and ultrafiltrate was present.<br />Conclusions: These suits demonstrate the feasibility and safety of regional citrate anticoagulation in severely burned and polytrauma septic patients treated by CPFA.
- Subjects :
- Acute Kidney Injury etiology
Acute Kidney Injury microbiology
Acute Kidney Injury therapy
Adult
Aged
Burns complications
Burns therapy
Calcium blood
Chemotherapy, Cancer, Regional Perfusion
Citric Acid blood
Contraindications
Critical Illness
Dialysis Solutions
Female
Hemorrhage prevention & control
Heparin administration & dosage
Humans
Male
Middle Aged
Multiple Trauma complications
Multiple Trauma therapy
Shock, Septic complications
Sorption Detoxification
Treatment Outcome
Anticoagulants therapeutic use
Citric Acid administration & dosage
Hemofiltration
Subjects
Details
- Language :
- English
- ISSN :
- 0253-5068
- Volume :
- 22
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Blood purification
- Publication Type :
- Academic Journal
- Accession number :
- 15256798
- Full Text :
- https://doi.org/10.1159/000078788