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Regional Citrate Anticoagulation

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https://www.readbyqxmd.com/read/27901553/a-prediction-and-simulation-model-for-target-oriented-regional-citrate-calcium-anticoagulation-in-extracorporeal-blood-purification
#1
Martin Brandl, Karlheinz Kellner
AIMS: Regional citrate-calcium anticoagulation is becoming more and more attractive for extracorporeal treatments in the clinical routine. METHODS: A prediction and simulation tool for the safe application of RCA during extracorporeal treatments was introduced. The model predicts the course of the ionized calcium level in the patient and the current anticoagulation status in the extracorporeal circuit based on the actual settings of the dialysis machine. RESULTS: The simulation tool delivers areas in which the blood and dialysate flow can be adjusted to reach the desired target values for RCA and predicts the time course of several parameters during treatment...
November 29, 2016: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/27896442/regional-citrate-anticoagulation-for-continuous-renal-replacement-therapy-in-children
#2
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
#3
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...
November 19, 2016: Blood Purification
https://www.readbyqxmd.com/read/27859540/the-impact-of-citrate-concentration-on-adhesion-of-platelets-and-leukocytes-to-adsorbents-in-whole-blood-lipoprotein-apheresis
#4
René Weiss, Michael B Fischer, Viktoria Weber
Lipoprotein apheresis is applied to deplete low density lipoprotein and other apolipoprotein B containing lipoproteins in patients with severe familial hypercholesterolemia, hypertriglyceridemia associated pancreatitis, or lipoprotein (a)-hyperlipoproteinemia. Anticoagulation of the extracorporeal circuit may influence cellular activation, as evidenced by a reduction of inflammatory parameters during regional citrate anticoagulation with acid citrate dextrose A (ACD-A) commonly used in whole blood lipid apheresis...
November 17, 2016: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/27852414/-survey-of-continuous-renal-replacement-therapy-application-status
#5
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/27786420/outcomes-of-continuous-renal-replacement-therapy-with-regional-citrate-anticoagulation-in-small-children-after-cardiac-surgery-experience-and-protocol-from-a-single-center
#6
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...
October 27, 2016: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/27669028/polymyxin-b-direct-hemoperfusion-using-regional-citrate-calcium-anticoagulation-a-case-report
#7
Anna Sidoti, Etrusca Brogi, Joshua Morse, Michele Collareta, Luigi Vetrugno, Francesco Giunta, Francesco Forfori
Direct hemoperfusion with polymyxin B (PMX-DHP) is an extracorporeal treatment to add to conventional therapy during unresponsive endotoxic septic shock. So far, only heparin has been used as an anticoagulant during polymyxin B therapy. We present a case report of a postsurgical septic patient treated with 2 cycles of PMX-DHP using citrate anticoagulation. Monitoring of serum calcium, postcartridge calcium, and acid-base balance was performed. The treatments were accomplished without complications. To our knowledge, this is the first published report on the use of citrate anticoagulation during PMX-DHP...
December 1, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27615524/citrate-anticoagulation-in-the-icu-the-leeds-experience
#8
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/27562561/chloride-content-of-solutions-used-for-regional-citrate-anticoagulation-might-be-responsible-for-blunting-correction-of-metabolic-acidosis-during-continuous-veno-venous-hemofiltration
#9
Rita Jacobs, Patrick M Honore, Marc Diltoer, Herbert D Spapen
BACKGROUND: Citrate, the currently preferred anticoagulant for continuous veno-venous hemofiltration (CVVH), may influence acid-base equilibrium. METHODS: The effect of 2 different citrate solutions on acid-base status was assessed according to the Stewart-Figge approach in two consecutive cohorts of critically ill adult patients. The first group received Prismocitrate 10/2 (PC10/2; 10 mmol citrate/L). The next group was treated with Prismocitrate 18/0 (PC18; 18 mmol citrate/L)...
2016: BMC Nephrology
https://www.readbyqxmd.com/read/27529346/regional-citrate-anticoagulation-for-continuous-renal-replacement-therapy-all-citrates-are-not-created-equal
#10
Rita Jacobs, Patrick M Honore, Inne Hendrickx, Herbert D Spapen
No abstract text is available yet for this article.
2016: Blood Purification
https://www.readbyqxmd.com/read/27494946/population-pharmacokinetics-of-cefuroxime-in-critically-ill-patients-receiving-continuous-venovenous-hemofiltration-with-regional-citrate-anticoagulation-and-a-phosphate-containing-replacement-fluid
#11
Paddy K C Janssen, Norbert A Foudraine, Desirée M T Burgers, Kees Neef, Jos L M L le Noble
BACKGROUND: Cefuroxime is frequently prescribed as an antimicrobial therapy in critically ill patients. The aim of this study was to develop a new intravenous dosing strategy for cefuroxime in critically ill patients undergoing continuous venovenous hemofiltration with regional citrate anticoagulation (RCA-CVVH) by analyzing its extracorporeal removal and pharmacokinetic (PK) parameters. METHODS: Nine critically ill patients treated with intravenous cefuroxime and RCA-CVVH and a phosphate-containing replacement fluid were investigated...
December 2016: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/27451145/accuracy-of-commercial-blood-gas-analyzers-for-monitoring-ionized-calcium-at-low-concentrations
#12
Paul D'Orazio, Helen Visnick, Shankar Balasubramanian
BACKGROUND: Variable ionized calcium measurements in post filter blood samples during continuous renal replacement therapy (renal dialysis) using regional citrate anticoagulation (RCA) have been reported using commercial blood gas analyzers, resulting in analyzer-dependent differences in decisions regarding adjustment of citrate dose. METHODS: We evaluated accuracy for measurement of iCa at low concentrations by 4 commercial blood gas analyzers using primary reference solutions formulated down to 0...
October 1, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/27427878/circuit-lifetime-with-citrate-versus-heparin-in-pediatric-continuous-venovenous-hemodialysis
#13
Tomáš Zaoral, Michal Hladík, Jana Zapletalová, Bořek Trávníček, Eliška Gelnarová
OBJECTIVES: To determine if there is a difference between regional citrate and global heparinized anticoagulation on circuit lifetimes during continuous venovenous hemodialysis in children. DESIGN: Prospective "cross-over" trial. SETTING: PICU, Department of Pediatrics, University Hospital Ostrava. PATIENTS: Children 0-18 years old. INTERVENTIONS: From 2009 to 2014, 63 eligible children (age, 89...
September 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27411455/determinants-of-calcium-infusion-rate-during-continuous-veno-venous-hemofiltration-with-regional-citrate-anticoagulation-in-critically-ill-patients-with-acute-kidney-injury
#14
De-Lin Liu, Li-Feng Huang, Wen-Liang Ma, Qi Ding, Yue Han, Yue Zheng, Wen-Xiong Li
BACKGROUND: It is unclear that how to decide the calcium infusion rate during continuous veno-venous hemofiltration (CVVH) with regional citrate anticoagulation (RCA). This study aimed to assess the determinants of calcium infusion rate during CVVH with RCA in critically ill patients with acute kidney injury (AKI). METHODS: A total of 18 patients with AKI requiring CVVH were prospectively analyzed. Postdilution CVVH was performed with a fixed blood flow rate of 150 ml/min and a replacement fluid flow rate of 2000 ml/h for each new circuit...
July 20, 2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27397987/characterization-of-promoter-sequence-of-toll-like-receptor-genes-in-vechur-cattle
#15
R Lakshmi, K K Jayavardhanan, T V Aravindakshan
AIM: To analyze the promoter sequence of toll-like receptor (TLR) genes in Vechur cattle, an indigenous breed of Kerala with the sequence of Bos taurus and access the differences that could be attributed to innate immune responses against bovine mastitis. MATERIALS AND METHODS: Blood samples were collected from Jugular vein of Vechur cattle, maintained at Vechur cattle conservation center of Kerala Veterinary and Animal Sciences University, using an acid-citrate-dextrose anticoagulant...
June 2016: Veterinary World
https://www.readbyqxmd.com/read/27391902/the-effects-of-high-level-magnesium-dialysis-substitution-fluid-on-magnesium-homeostasis-under-regional-citrate-anticoagulation-in-critically-ill
#16
Mychajlo Zakharchenko, Ferdinand Los, Helena Brodska, Martin Balik
BACKGROUND: The requirements for magnesium (Mg) supplementation increase under regional citrate anticoagulation (RCA) because citrate acts by chelation of bivalent cations within the blood circuit. The level of magnesium in commercially available fluids for continuous renal replacement therapy (CRRT) may not be sufficient to prevent hypomagnesemia. METHODS: Patients (n = 45) on CRRT (2,000 ml/h, blood flow (Qb) 100 ml/min) with RCA modality (4% trisodium citrate) using calcium free fluid with 0...
2016: PloS One
https://www.readbyqxmd.com/read/27352175/a-comparison-between-two-dilute-citrate-solutions-15-vs-18-mmol-l-in-continuous-renal-replacement-therapy-the-base-excess-and-renal-substitution-solution-study
#17
Chris Anstey, Victoria Campbell, Alexander Richardson
BACKGROUND/AIMS: The study aimed to compare the changes in biochemistry occurring in patients undergoing continuous renal replacement therapy (CRRT) using 2 trisodium citrate solutions, Baxter hemofiltration fluid containing 18 mmol/l (C18) and Baxter NamSol, a custom manufactured solution containing 15 mmol/l (C15), both delivered as regional citrate anticoagulation (RCA) predilution fluids for hemofiltration. METHODS: This is a prospective randomized control trial conducted in a major regional adult intensive care unit...
2016: Blood Purification
https://www.readbyqxmd.com/read/27312910/citrate-extended-high-cut-off-hemodiafiltration-for-renal-recovery-in-patients-with-multiple-myeloma
#18
Andreja Marn Pernat, Bojan Medved, Jakob Gubenšek, Vladimir Premru, Bojan Knap, Jadranka Buturovic-Ponikvar, Rafael Ponikvar
We proposed a combination of convective and diffusive transport mechanisms as high cut-off (HCO) post-dilution hemodiafiltration dialysis technique to optimize serum immunoglobulin free light chains (FLCs) removal which may improve dialysis dependent renal failure in patients with multiple myeloma. To reduce bleeding risk regional citrate anticoagulation was successfully used for the first 7 h followed by 1 h anticoagulant-free hemodiafiltration to avoid citrate accumulation. We retrospectively assessed the effect of FLCs reduction on the renal outcome of 28 patients treated with 133 citrate extended post-dilution HCO (Theralite 2100; Gambro, Lund, Sweden) hemodiafiltration sessions between 2010 and 2016...
June 2016: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/27312907/is-regional-citrate-anticoagulation-the-future-of-hemodialysis
#19
Jadranka Buturovic-Ponikvar
Citrate has many characteristics of the ideal anticoagulant for hemodialysis. In addition to immediate and complete anticoagulation in the dialysis circuit, citrate has important effects beyond anticoagulation, mainly in reducing inflammatory response induced by hemodialysis. Citrate has already become the standard anticoagulant in acute kidney injury requiring continuous renal replacement therapy (CRRT), both for adults and children, with the citrate module being a part of modern CRRT monitors. Although the citrate module is not yet available for intermittent hemodialysis, precise infusion pumps, point-of-care ionometers and high citrate clearance from high flux dialyzers increase safety while reducing the risk of metabolic complications, both in adult and pediatric patients...
June 2016: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/27290016/blood-transfusion-requirements-and-filter-longevity-with-regional-citrate-anticoagulation-compared-with-heparin
#20
E Burford, E Walter, A Beverly
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
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