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anticoagulation renal replacement therapy

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https://www.readbyqxmd.com/read/28219324/non-anti-coagulant-factors-associated-with-filter-life-in-continuous-renal-replacement-therapy-crrt-a-systematic-review-and-meta-analysis
#1
Matthew Brain, Elizabeth Winson, Owen Roodenburg, John McNeil
BACKGROUND: Optimising filter life and performance efficiency in continuous renal replacement therapy has been a focus of considerable recent research. Larger high quality studies have predominantly focussed on optimal anticoagulation however CRRT is complex and filter life is also affected by vascular access, circuit and management factors. We performed a systematic search of the literature to identify and quantify the effect of vascular access, circuit and patient factors that affect filter life and presented the results as a meta-analysis...
February 20, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28219057/preventing-continuous-renal-replacement-therapy-induced-hypophosphatemia-an-extended-clinical-experience-with-a-phosphate-containing-solution-in-the-setting-of-regional-citrate-anticoagulation
#2
Valentina Pistolesi, Laura Zeppilli, Francesca Polistena, Maria Itala Sacco, Alessandro Pierucci, Luigi Tritapepe, Giuseppe Regolisti, Enrico Fiaccadori, Santo Morabito
AIMS: To evaluate the efficacy and safety of a commercially available phosphate-containing solution for continuous renal replacement therapy (CRRT) in preventing CRRT-related hypophosphatemia. METHODS: In heart surgery patients undergoing continuous veno-venous haemodiafiltration (CVVHDF) with regional citrate anticoagulation (RCA), we combined an 18 mmol/l citrate solution with a phosphate-containing (1.2 mmol/l) dialysate/replacement fluid evaluating the incidence of hypophosphatemia and the need for parenteral phosphorus supplementation...
February 21, 2017: Blood Purification
https://www.readbyqxmd.com/read/28197045/experiences-with-continuous-venovenous-hemofiltration-using-18mmol-l-predilution-citrate-anticoagulation-and-a-phosphate-containing-replacement-solution
#3
Yuen Henry Jeffrey, Shum Hoi-Ping, Anne Leung Kit Hung, Lam Chung-Ling, Yan Wing-Wa, Lai King-Yiu
CONTEXT: Regional citrate anticoagulation for continuous renal replacement therapy is associated with a longer filter-life, less bleeding events and improved mortality. Problems associated with using Prismocitrate 10/2 solution in continuous renal replacement therapy, include hypomagnesemia, hypophosphatemia and the need for additional bicarbonate infusion. AIMS: This study uses the new Prismocitrate 18/0 solution for improved buffer balance and Phoxilium solution for a more favourable electrolyte profile...
January 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28164512/critical-deviations-of-ionized-calcium-measurements-when-using-blood-gas-analyzers-to-monitor-citrate-dialysis
#4
Thorsten Feldkamp, Norbert Weiler, Michael Marx, Peter B Luppa, Ralf Junker
BACKGROUND: During the course of acute kidney injury (AKI) patients may require renal replacement therapy (RRT). The preferred therapeutic measure for such patients is continuous RRT (CRRT). Anticoagulation is required to prevent clotting of the extracorporeal circuit. The actual KDIGO guidelines recommend citrate as the first line anticoagulant. METHODS: Citrate dose infused into the extracorporeal circuit should achieve an extracorporeal calcium concentration of 0...
October 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28138736/the-intensive-care-medicine-agenda-on-acute-kidney-injury
#5
REVIEW
Peter Pickkers, Marlies Ostermann, Michael Joannidis, Alexander Zarbock, Eric Hoste, Rinaldo Bellomo, John Prowle, Michael Darmon, Joseph V Bonventre, Lui Forni, Sean M Bagshaw, Miet Schetz
Acute kidney injury (AKI) is a common complication in the critically ill. Current standard of care mainly relies on identification of patients at risk, haemodynamic optimization, avoidance of nephrotoxicity and the use of renal replacement therapy (RRT) in established AKI. The detection of early biomarkers of renal tissue damage is a recent development that allows amending the late and insensitive diagnosis with current AKI criteria. Increasing evidence suggests that the consequences of an episode of AKI extend long beyond the acute hospitalization...
January 30, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28122702/major-publications-in-the-critical-care-pharmacotherapy-literature-in-2015
#6
Adrian Wong, Michael Erdman, Drayton A Hammond, Tara Holt, Jenna M Holzhausen, Michelle Horng, Lori Lynn Huang, Jennifer Jarvis, Bridgette Kram, Shawn Kram, Christine Lesch, Jessica Mercer, Megan A Rech, Ryan Rivosecchi, Brian Stump, Colleen Teevan, Sarah Day
PURPOSE: Recently published practice guidelines and research reports on pharmacotherapy in critical care patient populations are summarized. SUMMARY: The Critical Care Pharmacotherapy Literature Update (CCPLU) Group is composed of over 50 experienced critical care pharmacists who evaluate 31 peer-reviewed journals monthly to identify literature pertaining to pharmacotherapy in critical care populations. Articles are chosen for summarization in a monthly CCPLU Group publication on the basis of applicability and relevance to clinical practice and strength of study design...
January 25, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28118627/prostacyclin-as-an-anticoagulant-for-continuous-renal-replacement-therapy-in-children
#7
Akash Deep, Mohammad Zoha, Pompa Dutta Kukreja
Effective delivery of continuous renal replacement therapy (CRRT) depends on the longevity of the filter and circuit used in the CRRT machine. Safe and effective anticoagulation is crucial for maintaining the patency of these circuits. In children, heparin and citrate are the commonly used anticoagulants but they are limited by serious side effects and thus calls for meticulous monitoring. In conditions where neither of these can be used, prostacyclin can be an effective alternative. Prostacyclin is a platelet inhibitor that can be safely used as an efficient anticoagulant in CRRT...
January 25, 2017: Blood Purification
https://www.readbyqxmd.com/read/28070667/erratum-to-regional-citrate-anticoagulation-for-continuous-renal-replacement-therapy-in-children
#8
Mayerly Prada Rico, Jaime Fernández Sarmiento, Ana María Rojas Velasquez, Luz Stella González Chaparro, Ricardo Gastelbondo Amaya, Hernando Mulett Hoyos, Daniel Tibaduiza, Ana Maria Quintero Gómez
No abstract text is available yet for this article.
January 9, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28058458/-vitamin-k-antagonists-is-their-prescription-really-medical-malpractice-%C3%A2-today
#9
E Rafflenbeul, J Müller-Ehmsen
Atrial fibrillation and venous thromboembolisms are frequent cardiovascular diseases. Until a few years ago only vitamin K antagonists (VKA) were available for oral anticoagulation as primary and secondary prevention of thrombembolic events. Currently, the non-vitamin K dependent new oral anticoagulants (NOAC) dabigatran, rivaroxaban, apixaban and edoxaban are approved for use. The approval studies, meta-analyses and data from registries provide evidence for the superiority of NOAC vs. VKA with respect to reduction of thrombembolisms and reduced bleeding complications; therefore, in the 2016 European Society of Cardiology (ESC) guidelines the use of NOAC is recommended as first line therapy for anticoagulation in atrial fibrillation (recommendation grade I/evidence level A)...
January 2017: Der Internist
https://www.readbyqxmd.com/read/28044236/vascular-adhesion-protein-1-in-hemodialysis-and-hemodiafiltration-patients-effect-of-single-hemodialysis-session-on-its-level-in-regard-to-type-of-anticoagulant
#10
Jolanta Malyszko, Ewa Koc-Zorawska, Piotr Kozminski, Jacek S Malyszko
PURPOSE: Traditional anticoagulants used in intermittent hemodialysis (HD) are unfractionated heparin (UFH) and increasingly low molecular weight heparins (LMWHs). Repeated and prolonged exposure to UFH and/or LMWHs may further disturb hemostasis in uremic patients. Vascular adhesion protein-1 (VAP-1) is secreted by vascular smooth muscle cells, adipocytes and endothelial cells with functional monoamine oxidase activity and is elevated in atherosclerosis, diabetes mellitus and obesity...
January 2, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/27926465/freestyle-stentless-bioprosthesis-for-aortic-valve-therapy-17-year-clinical-results
#11
Juergen Ennker, Markus Meilwes, Joern Pons-Kuehnemann, Bernd Niemann, Philippe Grieshaber, Ina C Ennker, Andreas Boening
BACKGROUND: Aortic valve replacement with stentless bioprostheses has been shown to produce lower aortic gradients than stented bioprostheses, thus facilitating left ventricular mass regression and preventing heart failure. We sought to determine the long-term results of stentless biological aortic valve replacement over a 17-year follow-up. METHODS: Between 1996 and 2012, 2551 patients underwent isolated aortic valve replacement with a stentless prosthesis (Medtronic Freestyle) at a single center...
November 2016: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/27913748/a-3-year-follow-up-of-a-patient-with-acute-renal-failure-caused-by-thrombotic-microangiopathy-related-to-antiphospholipid-syndrome-case-report
#12
X-J Zhou, M Chen, S-X Wang, F-D Zhou, M-H Zhao
BACKGROUND: Microvascular manifestations of antiphospholipid antibody syndrome in the kidneys include acute renal failure, thrombotic microangiopathy and hypertension. Therapy has been largely empiric. CASE REPORT: A 49-year-old Chinese man presented with anuric acute renal failure without abundant proteinuria and heavy haematuria, but markedly low levels of urinary sodium, potassium and chlorine upon admission. On day 1 of hospitalization, his thrombocytopenia, anaemia and renal failure showed rapid progression...
December 2, 2016: Lupus
https://www.readbyqxmd.com/read/27896442/regional-citrate-anticoagulation-for-continuous-renal-replacement-therapy-in-children
#13
Mayerly Prada Rico, Jaime Fernández Sarmiento, Ana María Rojas Velasquez, Luz Stella González Chaparro, Ricardo Gastelbondo Amaya, Hernando Mulett Hoyos, Daniel Tibaduiza, Ana Maria Quintero Gómez
BACKGROUND: Anticoagulation of the continuous renal replacement therapy (CRRT) circuit is an important technical aspect of this medical procedure. Most studies evaluating the efficacy and safety of citrate use have been carried out in adults, and little evidence is available for the pediatric patient population. The aim of this study was to compare regional citrate anticoagulation versus systemic heparin anticoagulation in terms of the lifetime of hemofilters in a pediatric population receiving CRRT at a pediatric center in Bogota, Colombia...
November 28, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27866200/implementation-of-a-simplified-regional-citrate-anticoagulation-protocol-for-post-dilution-continuous-hemofiltration-using-a-bicarbonate-buffered-calcium-containing-replacement-solution
#14
Christopher J Kirwan, Ross Hutchison, Sherif Ghabina, Stephanie Schwarze, Abigail Beane, Susan Ramsay, Edward Thompson, John R Prowle
BACKGROUND/AIMS: Recent updates to the Nikkiso Aquarius continuous renal replacement therapy (CRRT) platform allowed us to develop a post-dilution protocol for regional citrate anticoagulation (RCA) using standard bicarbonate buffered, calcium containing replacement solution with acid citrate dextrose formula-A as a citrate source. Our objective was to demonstrate that the protocol was safe and effective. METHODS: Prospective audit of consecutive patients receiving RCA for CRRT within intensive care unit, who were either contraindicated to heparin or had poor filter lifespan (<12 h for 2 consecutive filters) on heparin...
2016: Blood Purification
https://www.readbyqxmd.com/read/27852414/-survey-of-continuous-renal-replacement-therapy-application-status
#15
C S Yang, Y Yang, L W Huang, X W Zhang, S Q Liu, H B Qiu
Objective: To investigate the condition of implementation of continuous renal replacement therapy (CRRT) in quality control center of critical care medicine. Methods: Questionnaire mails were issued to all of the quality control respondents to survey the application of CRRT in June 2015 from Jiangsu quality control center of critical care medicine. Results: Among the 69 quality control respondents, 62 were equipped with CRRT devices, and in 58 of which patients were treated with CRRT. There were 195 doctors and 253 nurses in 62 quality control respondents attended CRRT training at or above the provincial level; the proportions of hospitals in southern, central and northern regions of Jiangsu were 63%, 79% and 86% respectively with trained doctors (more than 2), and 34%, 38% and 43% respectively with trained nurses (more than 3)...
October 25, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27796019/-renal-failure-management-of-uremic-condition-and-replacement-therapy
#16
Riccardo Magistroni, Giovanna Capolongo, Giovanni Piscopo
Replacement therapy implemented by renal transplantation is preferable to dialysis treatment and also in uremic population with ADPKD. In preparation for the transplant nephrectomy is a procedure associated with morbidity and mortality in patient with ADPKD, it should be performed on the basis of stringent clinical indications. When the kidney transplant is not possible, peritoneal dialysis in appropriate patients is not contraindicated with comparable results to the extracorporeal dialytic treatment. The therapeutic targets in substitution treatment with respect to pressure levels, lipids, hemoglobin, anticoagulation regime are comparable to the non ADPKD uremic population...
September 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/27786420/outcomes-of-continuous-renal-replacement-therapy-with-regional-citrate-anticoagulation-in-small-children-after-cardiac-surgery-experience-and-protocol-from-a-single-center
#17
Anna Musielak, Alfred Warzywoda, Michał Wojtalik, Bartłomiej Kociński, Paweł Kroll, Danuta Ostalska-Nowicka, Jacek Zachwieja
Patients after a cardiac surgery in cardiopulmonary bypass often present an acute kidney failure. Continuous renal replacement therapy (CRRT) is often required. The aim of this study was to present effectiveness and safety of CRRT with regional citrate anticoagulation (RCA-CRRT) in small children after cardiac surgery. A retrospective analysis was conducted on 15 patients after cardiac surgery and who had RCA-CRRT performed in 2014. The established protocol was followed. Mean time on the RCA-CRRT was 192 h 40 min with the circuit mean lifetime of 43 h 33 min...
December 2016: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/27615524/citrate-anticoagulation-in-the-icu-the-leeds-experience
#18
Charlotte Trumper
Continuous renal replacement therapy (CRRT) is widely used in the management of critically ill patients with acute kidney injury. It requires effective anticoagulation of the extracorporeal blood circuit. Although heparin is the most commonly prescribed anticoagulant, there are issues associated with heparin, and there has been increasing interest in regional citrate anticoagulation as an alternative. In 2013, The Leeds Teaching Hospitals NHS Trust switched from heparin to citrate anticoagulant for CRRT in intensive care units (ICUs) across the Trust...
September 8, 2016: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/27585044/anticoagulation-in-continuous-renal-replacement-therapy-citrate-appears-to-be-superior-to-heparin
#19
Timothy E Bunchman
No abstract text is available yet for this article.
September 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27577028/total-artificial-heart-and-chronic-haemodialysis-a-possible-bridge-to-transplantation
#20
Julien Demiselle, Virginie Besson, Johnny Sayegh, Jean-François Subra, Jean-François Augusto
BACKGROUND: Total artificial heart (TAH) device is sometimes necessary to treat end stage heart failure (HF). After surgery, renal impairment can occur with the need of renal replacement therapy. METHOD: We report the case of a 51-year-old man who was treated with conventional hemodialysis (HD) while on support with TAH. RESULTS: The patient underwent HD while on TAH support during 14 months. He benefited from conventional HD, 6 sessions per week...
2016: Blood Purification
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