Citrate anticoagulation during CVVH in high risk bleeding patients

Lucia Cubattoli, M. Teruzzi, M. Cormio, L. Lampati, A. Pesenti

Research output: Contribution to journalArticle

Abstract

Background: Regional citrate anticoagulation (RCA) is an effective form of anticoagulation for continuous renal replacement therapy (CRRT) in patients with contraindications to heparin. Its use has been very limited, possibly because of the need for special infusion solutions and difficult monitoring of the metabolic effects. Objective: To investigate the safety and the feasibility of an RCA method for continuous veno-venous hemofiltration (CVVH) using commercially available replacement fluid. Methods: We evaluated 11 patients at high risk of bleeding, requiring CVVH. RCA was performed using commercially available replacement fluid solutions to maintain adequate acid-base balance. We adjusted the rate of citrate infusion to achieve a post-filter ionized calcium concentration [iCa] 250 ml/min. When needed, we infused calcium gluconate to maintain systemic plasma [iCa] within the normal range. Results: Twenty-nine filters ran for a total of 965.5 h. Average filter life was 33.6±20.5 h. Asymptomatic hypocalcemia was detected in 6.9% of all samples. No [iCa] values

Original languageEnglish
Pages (from-to)244-252
Number of pages9
JournalInternational Journal of Artificial Organs
Volume30
Issue number3
Publication statusPublished - Mar 2007

Fingerprint

Hemofiltration
Citric Acid
Calcium
Hemorrhage
Calcium Gluconate
Renal Replacement Therapy
Fluids
Acid-Base Equilibrium
Hypocalcemia
Heparin
Reference Values
Plasmas
Safety
Monitoring

Keywords

  • Acute renal failure
  • Bleeding complications
  • Citrate toxicity
  • Hemofiltration
  • Trisodium citrate

ASJC Scopus subject areas

  • Biophysics

Cite this

Cubattoli, L., Teruzzi, M., Cormio, M., Lampati, L., & Pesenti, A. (2007). Citrate anticoagulation during CVVH in high risk bleeding patients. International Journal of Artificial Organs, 30(3), 244-252.

Citrate anticoagulation during CVVH in high risk bleeding patients. / Cubattoli, Lucia; Teruzzi, M.; Cormio, M.; Lampati, L.; Pesenti, A.

In: International Journal of Artificial Organs, Vol. 30, No. 3, 03.2007, p. 244-252.

Research output: Contribution to journalArticle

Cubattoli, L, Teruzzi, M, Cormio, M, Lampati, L & Pesenti, A 2007, 'Citrate anticoagulation during CVVH in high risk bleeding patients', International Journal of Artificial Organs, vol. 30, no. 3, pp. 244-252.
Cubattoli, Lucia ; Teruzzi, M. ; Cormio, M. ; Lampati, L. ; Pesenti, A. / Citrate anticoagulation during CVVH in high risk bleeding patients. In: International Journal of Artificial Organs. 2007 ; Vol. 30, No. 3. pp. 244-252.
@article{bfd62278dc724f9597efce203c422173,
title = "Citrate anticoagulation during CVVH in high risk bleeding patients",
abstract = "Background: Regional citrate anticoagulation (RCA) is an effective form of anticoagulation for continuous renal replacement therapy (CRRT) in patients with contraindications to heparin. Its use has been very limited, possibly because of the need for special infusion solutions and difficult monitoring of the metabolic effects. Objective: To investigate the safety and the feasibility of an RCA method for continuous veno-venous hemofiltration (CVVH) using commercially available replacement fluid. Methods: We evaluated 11 patients at high risk of bleeding, requiring CVVH. RCA was performed using commercially available replacement fluid solutions to maintain adequate acid-base balance. We adjusted the rate of citrate infusion to achieve a post-filter ionized calcium concentration [iCa] 250 ml/min. When needed, we infused calcium gluconate to maintain systemic plasma [iCa] within the normal range. Results: Twenty-nine filters ran for a total of 965.5 h. Average filter life was 33.6±20.5 h. Asymptomatic hypocalcemia was detected in 6.9{\%} of all samples. No [iCa] values",
keywords = "Acute renal failure, Bleeding complications, Citrate toxicity, Hemofiltration, Trisodium citrate",
author = "Lucia Cubattoli and M. Teruzzi and M. Cormio and L. Lampati and A. Pesenti",
year = "2007",
month = "3",
language = "English",
volume = "30",
pages = "244--252",
journal = "International Journal of Artificial Organs",
issn = "0391-3988",
publisher = "Wichtig Publishing",
number = "3",

}

TY - JOUR

T1 - Citrate anticoagulation during CVVH in high risk bleeding patients

AU - Cubattoli, Lucia

AU - Teruzzi, M.

AU - Cormio, M.

AU - Lampati, L.

AU - Pesenti, A.

PY - 2007/3

Y1 - 2007/3

N2 - Background: Regional citrate anticoagulation (RCA) is an effective form of anticoagulation for continuous renal replacement therapy (CRRT) in patients with contraindications to heparin. Its use has been very limited, possibly because of the need for special infusion solutions and difficult monitoring of the metabolic effects. Objective: To investigate the safety and the feasibility of an RCA method for continuous veno-venous hemofiltration (CVVH) using commercially available replacement fluid. Methods: We evaluated 11 patients at high risk of bleeding, requiring CVVH. RCA was performed using commercially available replacement fluid solutions to maintain adequate acid-base balance. We adjusted the rate of citrate infusion to achieve a post-filter ionized calcium concentration [iCa] 250 ml/min. When needed, we infused calcium gluconate to maintain systemic plasma [iCa] within the normal range. Results: Twenty-nine filters ran for a total of 965.5 h. Average filter life was 33.6±20.5 h. Asymptomatic hypocalcemia was detected in 6.9% of all samples. No [iCa] values

AB - Background: Regional citrate anticoagulation (RCA) is an effective form of anticoagulation for continuous renal replacement therapy (CRRT) in patients with contraindications to heparin. Its use has been very limited, possibly because of the need for special infusion solutions and difficult monitoring of the metabolic effects. Objective: To investigate the safety and the feasibility of an RCA method for continuous veno-venous hemofiltration (CVVH) using commercially available replacement fluid. Methods: We evaluated 11 patients at high risk of bleeding, requiring CVVH. RCA was performed using commercially available replacement fluid solutions to maintain adequate acid-base balance. We adjusted the rate of citrate infusion to achieve a post-filter ionized calcium concentration [iCa] 250 ml/min. When needed, we infused calcium gluconate to maintain systemic plasma [iCa] within the normal range. Results: Twenty-nine filters ran for a total of 965.5 h. Average filter life was 33.6±20.5 h. Asymptomatic hypocalcemia was detected in 6.9% of all samples. No [iCa] values

KW - Acute renal failure

KW - Bleeding complications

KW - Citrate toxicity

KW - Hemofiltration

KW - Trisodium citrate

UR - http://www.scopus.com/inward/record.url?scp=34248402534&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34248402534&partnerID=8YFLogxK

M3 - Article

C2 - 17417764

AN - SCOPUS:34248402534

VL - 30

SP - 244

EP - 252

JO - International Journal of Artificial Organs

JF - International Journal of Artificial Organs

SN - 0391-3988

IS - 3

ER -