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Citrate AND anticoagulation

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https://www.readbyqxmd.com/read/29126301/coagulation-testing-in-the-core-laboratory
#1
William E Winter, Sherri D Flax, Neil S Harris
Primary hemostasis begins with endothelial injury. VWF, produced by endothelial cells, binds to platelets and links them to subendothelial collagen. Platelet-derived ADP and thromboxane activate non-adhered platelets via their GPIIb/IIIa receptors, allowing these platelets to participate in platelet aggregation. Secondary hemostasis is initiated with the binding of factor VII to extravascular tissue factor (TF). Factors II, VII, IX and X are vitamin K-dependent factors. The role of vitamin K is to assist in the addition of gamma carboxylate groups to glutamic acids in the "GLA" domains of these factors...
November 8, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/29123570/cyclophosphamide-and-regional-citrate-anticoagulation-a-sour-combination
#2
Tim Hendra, Jonathan Simon, Alastair Lowe
We present a case of a woman in her 70 s, on cyclophosphamide for multiple myeloma, who was admitted to critical care with grade III acute kidney injury. Renal replacement therapy with regional citrate anticoagulation was commenced. Shortly thereafter her systemic-ionised calcium levels fell and remained stubbornly low until post-filter calcium return was doubled. Her total-to-ionised calcium ratio gradually increased and so, to avoid further accumulation of citrate, anticoagulation was changed to heparin...
November 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/29118829/evaluating-the-safety-and-efficacy-of-regional-citrate-compared-to-systemic-heparin-as-anticoagulation-for-continuous-renal-replacement-therapy-in-critically-ill-patients-a-service-evaluation-following-a-change-in-practice
#3
Roberta Borg, Debra Ugboma, Dawn-Marie Walker, Richard Partridge
Following the implementation of citrate anticoagulation for continuous renal replacement therapy, we evaluate its first year of use and compare it to the previously used heparin, to assess whether our patients benefit from the recently reported advantages of citrate. We retrospectively analysed 2 years of data to compare the safety and efficacy of citrate versus heparin. The results have shown that 43 patients received continuous renal replacement therapy with heparin, 37 patients with citrate. We found no significant difference in metabolic control of pH, urea and creatinine after 72 h...
August 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/29045980/-anti-neutrophil-cytoplasmic-antibodies-associated-vasculitis-with-lung-hemorrhage-in-the-patient-on-maintenance-haemodialysis-a-case-report
#4
J X Ding, M Wang
Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) is usually a multisystem disorder, and pulmonary renal syndrome is a common presentation. Patients with AAV are less likely to experience relapse when they progress to end-stage renal disease (ESRD). We report a rare case of diffuse alveolar hemorrhage (DAH) in relapsing AAV after eight years of haemodialysis. A 58-year-old woman was admitted to our hospital with the chief complaints of dyspnea and hemoptysis accompanied by anemia, fever, fatigue, and weight loss...
October 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29027706/regional-citrate-anticoagulation-with-calcium-replacement-in-pediatric-apheresis
#5
Katie Sigler, Ji Lee, Poyyapakkam Srivaths
PURPOSE: The objective of this retrospective analysis was to present our single-center experience with intravenous (IV) calcium replacement and regional citrate anticoagulation in pediatric apheresis therapy with the aim of developing a standard operating procedure to minimize symptomatic hypocalcemia. METHODS: We analyzed apheresis procedures in patients <18 years of age over a 2-year time period (Jan 2012 to Dec 2014). Procedures in tandem with other extracorporeal therapies, including continuous renal replacement therapy, extracorporeal liver support, and extracorporeal membrane oxygenation, were excluded...
October 13, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/29022989/prophylactic-intravenous-calcium-therapy-for-exchange-blood-transfusion-in-the-newborn
#6
REVIEW
Tinuade A Ogunlesi, Foluso Ea Lesi, Olabisi Oduwole
BACKGROUND: Exchange blood transfusion (EBT) is a form of whole blood transfusion in which the total blood volume is replaced within a few hours. In perinatal and neonatal medicine, EBT is most often used in the management of severe anaemia or severe hyperbilirubinaemia in the first week of life. Hypocalcaemia, one of the common morbidities associated with EBT, is thought to arise from the chelating effects of the citrate commonly used as an anticoagulant in the donor's blood. This disorder manifests with muscular and nervous irritability and cardiac arrhythmias...
October 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28979536/citrate-versus-non-citrate-anticoagulation-in-continuous-renal-replacement-therapy-results-following-a-change-in-local-critical-care-protocol
#7
Samina R Chowdhury, Tom Lawton, Aaqid Akram, Robert Collin, James Beck
Continuous renal replacement therapy necessitates the use of anticoagulation. The anticoagulant of choice has traditionally been heparin. Emerging evidence has highlighted the deleterious effects of systemic heparin anticoagulation in the critically ill. Regional citrate anticoagulation has been used as an alternative in the setting of continuous renal replacement therapy. Our retrospective before-and-after cohort study aimed to ascertain if regional citrate anticoagulation is associated with any benefit in terms of circuit longevity, rates of complications, blood transfusion requirements and mortality, when introduced to a large general intensive care unit with a case mix of acute medical patients and acute and elective surgical patients...
February 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/28979523/blood-transfusion-and-filter-set-requirements-with-citrate-anticoagulation-compared-with-heparin-in-renal-replacement-therapy
#8
Nick Taylor, Edward Walter
No abstract text is available yet for this article.
November 2016: J Intensive Care Soc
https://www.readbyqxmd.com/read/28969597/the-effect-of-regional-citrate-anti-coagulation-on-the-coagulation-system-in-critically-ill-patients-receiving-continuous-renal-replacement-therapy-for-acute-kidney-injury-an-observational-cohort-study
#9
Richard Fisher, Katie Lei, Mike J Mitchell, Gary W Moore, Helen Dickie, Linda Tovey, Siobhan Crichton, Marlies Ostermann
BACKGROUND: Regional anticoagulation with citrate is the recommended first line treatment for patients receiving continuous renal replacement therapy (CRRT). There is wide variability in filter patency which may be due to differences in patient characteristics and local practice. It is also possible that citrate has effects on primary and secondary haemostasis, fibrinolysis and platelet function that are still unknown. The primary aim of the study is to describe the effect of citrate on coagulation and fibrinolysis pathways in both the patient and the haemodialysis circuit...
October 2, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28902664/comparison-of-the-inhibitory-mechanisms-of-diethyl-citrate-sodium-citrate-and-phosphonoformic-acid-on-calcification-induced-by-high-inorganic-phosphate-contents-in-mouse-aortic-smooth-muscle-cells
#10
Jian-Ming Ouyang, Chao-Yang Duan, Chong-Yu Zhang, Xin-Yuan Sun, Bao-Song Gui, Da Guo
OBJECTIVE: This study aimed to investigate the differences and inhibitory effects of diethyl citrate (Et2Cit), sodium citrate (Na3Cit), and phosphonoformic acid (PFA) on calcification induced by high inorganic phosphate (Pi) contents in mouse aortic smooth muscle cells (MOVAS) and to develop drugs that can induce anticoagulation and inhibit vascular calcification (VC). METHODS: Alive and fixed MOVAS were assessed for 14 days in the presence of high Pi with increasing Et2Cit, Na3Cit, and PFA concentrations...
September 11, 2017: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/28891412/a-novel-prothrombin-time-method-to-measure-all-non-vitamin-k-dependent-oral-anticoagulants-noacs
#11
Tomas L Lindahl, Kerstin Arbring, Maria Wallstedt, Mats Rånby
BACKGROUND: There is a clinical need for point-of-care (POC) methods for non-vitamin K-dependent oral anticoagulants (NOACs). We modified a routine POC procedure: Zafena's Simple Simon™ PT-INR, a room-temperature, wet-chemistry prothrombin time method of the Owren-type. METHODS: To either increase or decrease NOAC interference, two assay variants were devised by replacing the standard 10 µL end-to-end capillary used to add the citrated plasma sample to 200 µL of prothrombin time (PT) reagent by either a 20 µL or a 5 µL capillary...
August 2017: Upsala Journal of Medical Sciences
https://www.readbyqxmd.com/read/28878005/citrate-anticoagulant-improves-the-sensitivity-of-borreliella-borrelia-burgdorferi-plasma-culture
#12
LETTER
Adriana R Marques, Xiuli Yang, Alexis A Smith, Xuran Zhuang, Siu-Ping Turk, Carla D Williams, Melissa A Law, Alan G Barbour, Utpal Pal
No abstract text is available yet for this article.
November 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28871391/hemofiltration-induces-generation-of-leukocyte-derived-cd31-cd41-microvesicles-in-sepsis
#13
Georg Franz Lehner, Ulrich Harler, Clemens Feistritzer, Viktoria Maria Haller, Julia Hasslacher, Romuald Bellmann, Michael Joannidis
BACKGROUND: Microvesicles (MV) are extracellular vesicles known to be associated with cellular activation and inflammation. Hemofiltration is an effective blood purification technique for patients with renal failure and possibly also eliminates inflammatory mediators in the setting of sepsis. On the other hand, proinflammatory stimuli are induced by blood contacting the artificial membrane during extracorporeal blood purification. In chronic dialysis patients a systemic increase in MV has been described...
September 4, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28862718/clinical-impact-of-regional-citrate-anticoagulation-in-continuous-renal-replacement-therapy-in-critically-ill-patients
#14
Maria Huguet, Lida Rodas, Miquel Blasco, Luis F Quintana, Jordi Mercadal, Jose T Ortiz-Pérez, Irene Rovira, Esteban Poch
BACKGROUND: Regional citrate anticoagulation (RCA) is being used increasingly in continuous renal replacement therapy (CRRT) as a safer alternative to heparin. However, complex metabolic control to avoid side effects have generated discrepancies about its introduction into everyday practice. We aimed to compare both anticoagulation techniques in terms of efficacy, safety and feasibility. METHODS: Observational retrospective study performed in 3 specialized ICUs in patients receiving CVVHDF with RCA between January 2013 and May 2016...
August 17, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28857854/heparin-free-prolonged-intermittent-hemodialysis-using-calcium-free-citrate-dialysate-in-critically-ill-patients
#15
Stanislas Faguer, Morgane Saint-Cricq, Marie-Béatrice Nogier, Isabelle Labadens, Laurence Lavayssiere, Nassim Kamar, Olivier Cointault
OBJECTIVES: Critically ill patients who have a high risk of bleeding but require prolonged intermittent dialysis need a heparin-free easy-to-use alternative type of anticoagulation within the dialysis circuit. We assessed the safety and efficiency of heparin-free regional citrate anticoagulation of the dialysis circuit using a calcium-free citrate-containing dialysate, with calcium reinjected according to ionic dialysance. DESIGN: Prospective cohort study. SETTING: Critical care units...
November 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28844073/the-effects-of-dry-ice-exposure-on-plasma-ph-and-coagulation-analyses
#16
Lene Trondsetås, Gustav Mikkelsen, Ingrid Alsos Lian
BACKGROUND: We recently observed that exposure to dry ice lowered sample pH and increased clotting times in lupus anticoagulant analyses, and that such changes could be prevented by placing samples at -80°C after dry ice exposure. In the current study, we sought to evaluate the effects of dry ice exposure on pH and various commonly used coagulation analyses. METHODS: Citrated plasma from 30 healthy blood donors was allocated to four preanalytical regimes: (1) immediate analysis of fresh plasma or (2) storage at -20°C; (3) storage at -20°C followed by dry ice exposure for 24 h or (4) storage at -20°C followed by dry ice exposure for 24 h and storage at -80°C for 24 h before analysis...
August 28, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28843244/in-vitro-leukoagglutination-a-rare-hematological-cause-of-spurious-leukopenia
#17
Sadia Sultan, Syed Muhammad Irfan
Leukopenia secondary to leukocytic agglutination is caused by an ethylene diamine tetra acetic acid (EDTA) which may appear in both benign and malignant states. Ethylene diamine tetra acetic acid induced platelets clumping in peripheral blood has been well established, but invitro leukocytic aggregation is very rarest hematological finding. Pseudo-leukopenia resulting from leukoagglutinins has been reported in the cirrhotic state, infections, autoimmune disorders, uremia, in immunosuppressed state or in various malignancies...
June 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/28804816/preanalytical-issues-in-hemostasis-and-thrombosis-testing
#18
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
#19
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
#20
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
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