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Citrate anticoagulation

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https://www.readbyqxmd.com/read/28804816/preanalytical-issues-in-hemostasis-and-thrombosis-testing
#1
Giuseppe Lippi, Emmanuel J Favaloro
Hemostasis testing is critical to many hemorrhagic and thrombotic disorders, wherein laboratory diagnostics can provide critical information for diagnosis, prognostication, and therapeutic monitoring. Due to this crucial role in modern medicine, hemostasis tests should be carried out at their highest degree of quality, thus encompassing standardization and monitoring of all phases of the testing process. It is now clearly established that the preanalytical phase is the most critical and vulnerable part of the total testing process, since up to 70% of diagnostic errors are due to highly manual activities encompassing patient preparation and collection of biological samples, as well as handling, transportation, preparation and storage of blood specimens...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28792509/regional-citrate-anticoagulation-for-continuous-renal-replacement-therapy-in-pediatric-patients-with-liver-failure
#2
Keila Rodriguez, Poyyapakkam R Srivaths, Leyat Tal, Mary N Watson, Alyssa A Riley, Ryan W Himes, Moreshwar S Desai, Michael C Braun, Ayse Akcan Arikan
Pediatric liver failure patients frequently develop multiple organ failure and require continuous renal replacement therapy (CRRT) as part of supportive therapy in the pediatric intensive care unit. While many centers employ no anticoagulation for fear of bleeding complications, balanced coagulation disturbance predisposes these patients to clotting as well as bleeding, making maintenance of longer circuit life to deliver adequate dialysis clearance challenging. Regional citrate anticoagulation (RCA) is an attractive option as it avoids systemic anticoagulation, but since citrate metabolism is impaired in liver failure, concerns about toxicity has limited its use...
2017: PloS One
https://www.readbyqxmd.com/read/28781241/stent-malapposition-and-the-risk-of-stent-thrombosis-mechanistic-insights-from-an-in-vitro-model
#3
Nicolas Foin, Shengjie Lu, Jaryl Ng, Heerajnarain Bulluck, Derek J Hausenloy, Philip E Wong, Renu Virmani, Michael Joner
AIMS: To examine the effect of under-expansion on stent thrombogenicity with an in-vitro perfusion model. METHOD AND RESULTS: Drug eluting stent (DES) samples were partially under-deployed in silicone tubes and perfused with porcine blood containing 10% Anticoagulant Citrate Dextrose solution for 4 minutes at a flow rate of 200ml/min. Thrombus formation was evaluated and compared between the well apposed and malapposed sections. The malapposed sections showed significantly more thrombus formation compared to the well apposed sections (13...
August 8, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28777135/hematologic-disorders-in-children-with-continuous-renal-replacement-therapies
#4
Celia Fabra, Sara Infante, Isabel Miras, Susana Pretus, María José Santiago, Sarah N Fernández, Jesús López-Herce
The objective of this study was to analyze hematologic disorders, coagulation disorders, and transfusion requirements in children with continuous renal replacement therapies (CRRT). This is a retrospective analysis of a prospectively collected database of children receiving CRRT between 2010 and 2015. Patient characteristics, CRRT parameters, hematologic and coagulation parameters, and need for transfusions were recorded and analyzed. We compared patients after heart surgery and noncardiac patients, those requiring extracorporeal membrane oxygenation (ECMO) and those without ECMO, and patients with different anticoagulation therapies: heparin and citrate...
August 1, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28747619/comparison-of-commercially-available-blood-collection-tubes-containing-sodium-citrate-and-hirudin-in-platelet-aggregation-testing
#5
Walter J Janse van Rensburg, Patricia van der Merwe
BACKGROUND Platelet reactivity assessment is an important tool in both the causal determination of bleeding diathesis as well as in the evaluation of the efficacy of anti-platelet therapy in patients at risk of thrombosis. Sodium citrate is the most widely used anticoagulant for hemostasis investigations. However, some doubt exists over the suitability of sodium citrate in platelet function testing. Hirudin has been suggested as a superior replacement. Nevertheless, only 1 study compared citrated and hirudin treated samples with light transmission aggregometry...
July 27, 2017: Medical Science Monitor Basic Research
https://www.readbyqxmd.com/read/28708212/albumin-corrected-total-ionized-calcium-ratio-is-not-superior-to-total-ionized-calcium-ratio-as-an-indicator-of-citrate-accumulation
#6
Yin Zheng, Feng Zhuang, Qiuyu Zhu, Shuai Ma, Yao Xu, Jianxin Lu, Guihua Hao, Yong Gu, Chuanming Hao, Mingli Zhu, Feng Ding
BACKGROUND: Total/ionized calcium ratio has been used as an indirect index of increased plasma citrate concentration during citrate anticoagulation. However, they were obtained without any adjustment of total calcium for albumin. Herein, we investigated whether the albumin-corrected total/ionized calcium ratio performed better than total/ionized calcium ratio. METHODS: 20 critically ill patients were treated with continuous venovenous hemofiltration (CVVH) using citrate anticoagulation...
July 11, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28682569/-nephrologist-and-icu-the-need-of-new-expertise
#7
Filippo Mariano, Marco Pozzato
Episodes of dialytic Acute Kidney Injury (AKI stage III KDIGO) can lead to chronic kidney disease (CKD), even after a long time. Prelimary data indicate that the relationship between AKI and CKD is affected by dialysis technical modalities and factors in part modifiable, such as an early dialysis timing, dose adeguacy, continuous treatment, use of biocompatible membranes and regional citrate anticoagulation. However, in most ICUs involvement of nephrologist consultant is marginal. Of more, nephrological follow-up after discharge, which allows to slow down the progression rate of CKD even just by a correct pharmacological and dietetic approach (sartans, ACEis), is an uncommon practice...
April 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28673194/evaluation-of-ctad-citrate-theophylline-adenosine-dipyridamole-as-a-universal-anticoagulant-in-dogs
#8
Fanny A Granat, Anne Geffré, Laetitia A Lucarelli, Jean-Pierre D Braun, Catherine Trumel, Nathalie H Bourgès-Abella
CTAD (citrate-theophylline-adenosine-dipyridamole) has been shown to be an almost universal anticoagulant in human and feline medicine, allowing most hematology, coagulation, and biochemical analyses. Forty canine blood specimens were collected in CTAD, EDTA, heparin, and citrate for hematology, biochemistry, and coagulation analyses. CTAD partially limited platelet aggregation observed in EDTA blood smears. CTAD specimens gave similar and well-correlated results for most variables of a complete blood cell count, except for mean corpuscular volume, which was moderately higher, and mean corpuscular hemoglobin concentration, which was moderately lower in CTAD than in EDTA; reticulocyte and platelet indexes were poorly correlated...
June 1, 2017: Journal of Veterinary Diagnostic Investigation
https://www.readbyqxmd.com/read/28664840/anticoagulation-assessment-methods-in-plasma-exchange-with-regional-citrate-anticoagulation-evaluation-of-post-filter-and-filtered-plasma-ionized-calcium
#9
Manja Antonič, Jakob Gubenšek, Jadranka Buturović-Ponikvar, Rafael Ponikvar
AIM: To assess the possibility of using filtered plasma instead of postfilter ionized calcium (iCa) for the assessment of anticoagulation in plasma exchange (PE) with citrate anticoagulation. METHODS: 140 PE treatments were performed using either 4% or 15% citrate at a comparable dose. Paired samples of postfilter blood and filtered plasma were taken for iCa measurements with a point-of-care analyzer. Anticoagulation was also assessed with a bedside clotting time and visual assessment of the circuit after procedures...
June 30, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28643541/effects-of-ph-and-concentration-of-sodium-citrate-anticoagulant-on-platelet-aggregation-measured-by-light-transmission-aggregometry-induced-by-adenosine-diphosphate
#10
Ksenia Germanovich, Eti Alessandra Femia, Chun Yan Cheng, Natalia Dovlatova, Marco Cattaneo
The 2013 ISTH-SSC guidelines for the standardization of light transmission aggregometry (LTA) were largely based on expert consensus, as studies directly comparing LTA methodologies were lacking. We experimentally tested the cogency of ISTH-SSC recommendations pertaining to use of anticoagulant, in particular whether: (1) buffered citrate (BC) is preferable to unbuffered citrate (C); (2) the two recommended concentrations of sodium citrate (109 and 129 mM) are equivalent in terms of platelet aggregation (PA)...
June 23, 2017: Platelets
https://www.readbyqxmd.com/read/28629414/fibrinogen-deficiency-in-a-dog-a-case-report
#11
Franck Jolivet, Armelle Diquélou, Catherine Trumel, Simon Privat, Olivier Dossin
BACKGROUND: Among coagulation disorders, primary fibrinogen deficiency is very rare in dogs. It is divided into hypofibrinogenemia, afibrinogenemia and dysfibrinogenemia. Afibrinogenemia has been described in three dogs. There are, however, no published case reports of primary hypofibrinogenemia in dogs. CASE PRESENTATION: A 1.5 year-old male German Pointer dog was evaluated for a locked-jaw syndrome associated with eye protrusion which appeared after a minor head trauma...
June 19, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/28619392/platelet-satellitism-in-autoimmune-hemolytic-anemia
#12
REVIEW
I Ghariani, N Braham, S Hamzaoui, L Bekir
Platelet satellitism is a rare phenomenon observed in blood smears obtained from blood anticoagulated with EDTA with an estimated frequency at 0.008%. It is characterized by platelet rosetting around neutrophils and in rare cases around other blood cells, which may causes pseudothrombocytopenia. Our case involves a 26-year-old female patient with autoimmune hemolytic anemia (AIHA). Blood smear with EDTA as an anticoagulant had platelet satellitism whereas the phenomenon was not observed in tubes with different anticoagulants (citrate, heparin) and capillary blood...
April 2017: Current Research in Translational Medicine
https://www.readbyqxmd.com/read/28618127/regional-citrate-anticoagulation-in-membrane-based-plasma-exchange-safety-efficacy-and-effect-on-calcium-balance
#13
Daniel Christiadi, Chari Mercado, Richard Singer
AIM: To assess the efficacy, safety and calcium balance of a membrane based regional citrate anticoagulation plasma exchange protocol METHODS: This was an observational, prospective, single center study of membrane separation plasma exchange using regional citrate anticoagulation. It was performed using a fixed dose pre-filter citrate infusion that was based on the plasma flow rate. Patients received a post filter calcium infusion which was modified during treatment based on systemic ionized calcium monitoring...
June 15, 2017: Nephrology
https://www.readbyqxmd.com/read/28601642/comparison-of-citrated-and-fresh-whole-blood-for-viscoelastic-coagulation-testing-during-elective-neurosurgery
#14
E Silverberg, F Tornqvist, T Kander, J Bengzon, C Solomon, J Bonnevier, U Schött
BACKGROUND: Previous viscoelastic haemostatic tests studies have often indicated a hypercoagulative test signal with citrated blood, which could influence clinical decision makings. PURPOSE: The aim of this study was to compare fresh and citrated whole blood using two non-automated viscoelastic ROTEM and Sonoclot tests. Our hypothesis was that citrated blood would demonstrate a hypercoagulative response in this setting, not tested before. METHODS: Perioperative viscoelastic coagulation changes were evaluated with a ROTEM and Sonoclot in 38 patients undergoing elective brain tumor surgery...
June 3, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28595117/effect-of-the-anticoagulant-storage-time-and-temperature-of-blood-samples-on-the-concentrations-of-27-multiplex-assayed-cytokines-consequences-for-defining-reference-values-in-healthy-humans
#15
Linda Torrissen Hennø, Elin Storjord, Dorte Christiansen, Grete Bergseth, Judith Krey Ludviksen, Hilde Fure, Svein Barene, Erik Waage-Nielsen, Tom E Mollnes, Ole-Lars Brekke
Cytokines are potentially useful biomarkers of sepsis and other inflammatory conditions. Many cytokines can be released by leukocytes and platelets after sampling. The sampling and processing techniques are consequently critically important to measure the in vivo levels. We therefore examined the effects of four different anticoagulants, EDTA, citrate, lepirudin, heparin compared to serum, on the levels of 27 different cytokines. The effects of storage temperature, freezing and thawing on the plasma cytokines were examined...
September 2017: Cytokine
https://www.readbyqxmd.com/read/28584429/thromboelastography-for-evaluation-of-coagulopathy-in-nonbleeding-patients-with-sepsis-at-intensive-care-unit-admission
#16
Syed Nabeel Muzaffar, Arvind Kumar Baronia, Afzal Azim, Anupam Verma, Mohan Gurjar, Banani Poddar, Ratender Kumar Singh
BACKGROUND: Thromboelastography (TEG) is a global test of coagulation which analyzes the whole coagulation process. TEG is popular in trauma, liver transplant, and cardiac surgeries, but studies in sepsis are limited. We have assessed the utility of TEG for evaluating coagulopathy in nonbleeding patients with sepsis. MATERIALS AND METHODS: A prospective, observational study was done in 12-bedded Intensive Care Unit (ICU) of a tertiary care hospital in North India, during May 2014-November 2014...
May 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28582600/effect-of-time-and-temperature-on-anticoagulant-dependent-pseudothrombocytopenia-in-g%C3%A3-ttingen-minipigs
#17
Tim Erkens, Liesbeth Van den Sande, Jill Witters, Filip Verbraeken, Adriana Looszova, Bianca Feyen
BACKGROUND: A marked decrease in thrombocyte count was observed between subsequent measurements of the same EDTA blood sample in several minipigs, but little information was available explaining this finding. OBJECTIVES: The objective was to evaluate the impact of several preanalytic variables on thrombocyte counts in minipigs, in order to improve understanding of the in vitro thrombocyte decrease observed. MATERIALS AND METHODS: Hematology blood samples from male and female Göttingen minipigs were collected using EDTA or citrate as an anticoagulant...
June 5, 2017: Veterinary Clinical Pathology
https://www.readbyqxmd.com/read/28582421/circulating-fibroblast-activation-protein-activity-and-antigen-levels-correlate-strongly-when-measured-in-liver-disease-and-coronary-heart-disease
#18
Shirley Uitte de Willige, Fiona M Keane, David G Bowen, Joyce J M C Malfliet, H Emma Zhang, Bharvi Maneck, Geoffrey W McCaughan, Frank W G Leebeek, Dingeman C Rijken, Mark D Gorrell
BACKGROUND AND AIM: Circulating fibroblast activation protein (cFAP) is a constitutively active enzyme expressed by activated fibroblasts that has both dipeptidyl peptidase and endopeptidase activities. We aimed to assess the correlation between cFAP activity and antigen levels and to compare variations in levels. METHODS: In plasma of 465 control individuals, 368 patients with coronary heart disease (CHD) and 102 hepatitis C virus (HCV) infected patients with severe liver disease before and after liver transplant, cFAP activity levels were measured with a newly developed cFAP activity assay...
2017: PloS One
https://www.readbyqxmd.com/read/28578542/citrate-versus-heparin-anticoagulation-in-continuous-renal-replacement-therapy-in-small-children
#19
Paulien A M A Raymakers-Janssen, Marc Lilien, Ingrid A van Kessel, Esther S Veldhoen, Roelie M Wösten-van Asperen, Josephus P J van Gestel
BACKGROUND: Citrate is preferred over heparin as an anticoagulant in adult continuous renal replacement therapy (CRRT). However, its potential adverse effects and data on use in CRRT in infants and toddlers is limited. We conducted a prospective study on using citrate in CRRT in critically ill small children. METHODS: Children who underwent CRRT with the smallest filter in our PICU between November 2011 and November 2016 were included. Both heparin and citrate were applied according to a strict protocol...
June 4, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28578343/filter-size-not-the-anticoagulation-method-is-the-decisive-factor-in-continuous-renal-replacement-therapy-circuit-survival
#20
Monika Miklaszewska, Przemysław Korohoda, Katarzyna Zachwieja, Krzysztof Kobylarz, Constantinos J Stefanidis, Alina Sobczak, Dorota Drożdż
BACKGROUND/AIM: As continuous renal replacement therapy (CRRT) has emerged as a standard therapy in pediatric intensive care units (PICU), many related issues that may have an impact on circuit survival have gained in importance. Objective of the study was an evaluation of factors associated with circuit survival, including anticoagulation (ACG). METHODS: Retrospective study that included 40 patients, who in total received 7636 hours of CRRT during 150 sessions (84 filters, 4260 hours with heparin anticoagulation (Hep-ACG); 66 filters, 3376 hours with regional citrate anticoagulation (RCA))...
2017: Kidney & Blood Pressure Research
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