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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/27859427/citrate-buffered-dialysis-solution-citrasate-allows-avoidance-of-anticoagulation-during-intermittent-hemodiafiltration-at-the-cost-of-decreased-performance-and-systemic-biocompatibility
#5
Pavlina Richtrova, Jan Mares, Lukas Kielberger, Ladislav Trefil, Jaromir Eiselt, Tomas Reischig
Reportedly, citrate-based dialysis solution enables heparin dose tapering or even complete exclusion, particularly in postdilution hemodiafiltration (HDF). The aim of the study was to verify this strategy in predilution setting and to assess its short-term safety, efficacy, and biocompatibility. Ten regular hemodialysis patients were assigned to predilution HDF on acetate- and citrate-based dialysis solutions (0.8 mmol/l trisodium citrate) at random order. Acetate HDF was performed using routine dose of heparin while citrate HDF was heparin free...
November 10, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27859323/no-association-between-frequent-apheresis-donation-and-risk-of-fractures-a-retrospective-cohort-analysis-from-sweden
#6
Katrine Grau, Senthil K Vasan, Klaus Rostgaard, Walter Bialkowski, Rut Norda, Henrik Hjalgrim, Gustaf Edgren
BACKGROUND: Citrate anticoagulation during apheresis induces transient alterations in calcium homeostasis. It is unknown whether the repeated, transient alterations in calcium homeostasis experienced by repeated apheresis donors affects bone turnover to increase fracture risk. Our aim was to investigate the risk of osteoporotic and nonosteoporotic fracture among voluntary, frequent apheresis donors. STUDY DESIGN AND METHODS: All apheresis donors were identified from the Scandinavian Donations and Transfusions database (SCANDAT2), which includes information on over 1...
November 18, 2016: Transfusion
https://www.readbyqxmd.com/read/27852414/-survey-of-continuous-renal-replacement-therapy-application-status
#7
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/27811340/analysis-of-anticoagulants-for-blood-based-quantitation-of-amyloid-%C3%AE-oligomers-in-the-sfida-assay
#8
Kateryna Kravchenko, Andreas Kulawik, Maren Hülsemann, Katja Kühbach, Christian Zafiu, Yvonne Herrmann, Christina Linnartz, Luriano Peters, Tuyen Bujnicki, Johannes Willbold, Oliver Bannach, Dieter Willbold
Early diagnostics at the preclinical stage of Alzheimer's disease is of utmost importance for drug development in clinical trials and prognostic guidance. Since soluble Aβ oligomers are considered to play a crucial role in the disease pathogenesis, several methods aim to quantify Aβ oligomers in body fluids such as cerebrospinal fluid (CSF) and blood plasma. The highly specific and sensitive method surface-based fluorescence intensity distribution analysis (sFIDA) has successfully been established for oligomer quantitation in CSF samples...
November 2, 2016: Biological Chemistry
https://www.readbyqxmd.com/read/27810996/annals-express-stability-of-ionized-calcium-measurements-at-concentrations-less-than-0-3-mmol-l-by-point-of-care-blood-gas-instruments-application-for-post-filter-calcium-quality-control-in-patients-with-citrate-anticoagulation-during-extracorporeal-circulation
#9
Maria Averina, Raymond Jakobsen
: BackgroundMeasurements of ionized calcium (Ca(2)(+)) at concentrations less than 0.3 mmol/L are required for post-filter control in patients that receive extracorporeal circulation with sodium citrate anticoagulation. This study evaluates the stability of the Ca(2)(+) measurements at such concentrations. MethodsThe stability of the Ca(2)(+) measurements was tested by measuring daily the external standard Qualicheck concentration 3 s7950, Radiometer (0.22-0.25 mmol/L) by blood gas instruments ABL800 and ABL90, Radiometer...
November 3, 2016: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/27803814/is-anticoagulation-discontinuation-achievable-with-citrate-dialysate-during-hdf-sessions
#10
Thibault Dolley-Hitze, Emmanuel Oger, Didier Hamel, Marie-Laure Lombart, Isabelle Hermès
Citrate dialysate has been developed for few years to replace acetate and HCl concentrates. In Online Postdilution Hemodiafiltration (OL-POST-HDF), several issues are remaining concerning the possibility of stopping anticoagulation during sessions and the side effects of citrate solutions on calcium metabolism. This 1-year monocentric retrospective study included all patients exposed to citrate in OL-POST-HDF with nadroparin decrease for more than one month. Clotting events, serum calcium, PTH, hemoglobin, CRP, depuration parameters, and treatments administrated were recorded for analysis...
2016: International Journal of Nephrology
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
#11
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/27765678/effect-of-anticoagulants-on-the-protein-corona-induced-reduced-drug-carrier-adhesion-efficiency-in-human-blood-flows
#12
Daniel J Sobczynski, Omolola Eniola-Adefeso
: Plasma proteins rapidly coat the surfaces of particulate drug carriers to form a protein corona upon their injection into the bloodstream. The high presence of immunoglobulins in the corona formed on poly(lactic-co-glycolic acid) (PLGA) vascular-targeted carrier (VTC) surfaces was recently shown to negatively impact their adhesion to activated endothelial cells (aECs) in vitro. Here, we characterized the influence of anticoagulants, or their absence, on the binding efficiency of VTCs of various materials via modulation of their protein corona...
October 17, 2016: Acta Biomaterialia
https://www.readbyqxmd.com/read/27755018/end-user-evaluation-of-dg-pt-l-rec-a-human-recombinant-thromboplastin-in-liquid-formulation
#13
Núria Segarra, Joan Huguet, Beatriz Fernández-Forner
The objective is to evaluate Grifols' DG-PT L Rec liquid reagent for prothrombin time (PT) determination in comparison to the laboratory's reference reagent (Siemens' Thromborel S). For linearity, the average master curve for PT and five nominal prothrombin concentrations was obtained from five calibration curves. Within-assay precision (repeatability) was calculated after measuring 20 successive tests of normal and pathological controls. For correlation, 581 routine clinical citrated plasma samples were assessed with both reagents...
October 13, 2016: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/27704645/investigation-of-the-anticoagulant-and-antithrombotic-effects-of-chlorogenic-acid
#14
Jun-Hui Choi, Seung Kim
Thrombosis is a leading cause of morbidity and mortality throughout the world. Thrombolytic agents are important for both the prevention and treatment of thrombosis. Fibrin clot and turbidity assays revealed that it was able to inhibit the formation of fibrin clot. Chlorogenic acid degraded blood clot and inhibited the enzymatic activity of procoagulant proteases, thrombin, activated factor X (FXa), and activated factor XIII (FXIIIa). Chlorogenic acid was found to delay activated partial thromboplastin time, prothrombin time, and thrombin time...
October 5, 2016: Journal of Biochemical and Molecular Toxicology
https://www.readbyqxmd.com/read/27676234/comparative-evaluation-of-a-heparin-citrate-anticoagulation-for-ldl-apheresis-in-two-primary-apheresis-systems
#15
Doris Handschel, Michiel Etienne Janssens, Marion Gericke, Stef De Reys, Helmut Borberg
BACKGROUND: As COBE Spectra has been replaced in many parts of the world, we describe a new protocol for low-density lipoprotein (LDL)-apheresis performed on familial hypercholesterolemia patients for the Spectra Optia platform. METHODS: For all procedures, after administering a bolus of heparin of 2,500 U, 10,000 U of heparin added to a 600 ml ACD-A bag was used as anticoagulant (AC). In a first phase (A), 16 apheresis procedures with COBE Spectra using an inlet:AC ratio of 25:1 were compared to 18 LDL-apheresis treatments with Spectra Optia at split Inlet:AC ratios of 16:1/18:1 or 20:1/25:1...
September 27, 2016: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/27670267/the-clock-trial-a-double-blinded-randomized-controlled-trial-trisodium-citrate-30-and-minocycline-3-mg-ml-plus-edta-30-mg-ml-are-effective-and-safe-for-catheter-patency-maintenance-among-ckd-5d-patients-on-hemodialysis
#16
Marcus V S João Luiz, Cristoforo Scavone, Carmen Tzanno
Introduction Poor blood flow rate (PF) is highly prevalent among CKD 5D patients with long-term central venous catheters. Heparin catheter lock solutions are commonly used to maintain catheter patency, however the incidence of PF remains high. The purpose of the CLOCK Trial was to evaluate two catheter lock solutions on reduction of PF incidence. Methods Seventy-five CKD 5D patients on high-efficiency hemodialysis at the Integrated Centre of Nephrology (Guarulhos, Brazil) were randomized 1:1:1 to receive a lock solution combining minocycline 3 mg/mL with the anticoagulant/chelation agent EDTA 30 mg/mL (M-EDTA) or heparin 1000 IU/mL (H) or trisodium citrate 30% (TSC) vs...
September 26, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27669028/polymyxin-b-direct-hemoperfusion-using-regional-citrate-calcium-anticoagulation-a-case-report
#17
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/27645394/development-of-an-optical-detector-of-thrombus-formation-on-the-pivot-bearing-of-a-rotary-blood-pump
#18
Daisuke Sakota, Tatsuki Fujiwara, Katsuhiro Ouchi, Katsuyuki Kuwana, Hiroyuki Yamazaki, Osamu Maruyama
Continuous optical monitoring of thrombus formation in extracorporeal mechanical circulatory support (EMCS) devices will contribute to safe, long-term EMCS. A clinically applicable optical detector must be able to distinguish among the optical characteristics of oxygen saturation (SaO2 ), hematocrit (Hct), and thrombus formation. In vitro studies of spectral changes at wavelengths from 400 to 900 nm associated with SaO2 , Hct, and thrombus formed around the top pivot bearing of a Gyro C1E3 pump were conducted...
September 2016: Artificial Organs
https://www.readbyqxmd.com/read/27634983/the-necessity-of-using-heparin-in-an-ultratag%C3%A2-rbc-kit-when-tagging-blood-for-a-nuclear-medicine-study
#19
Sarah R Pigmon, Kara D Weatherman, Nicholas Brehl, Cybil J Nielsen
: The purpose of this research is to evaluate the necessity of using heparin in UltraTag™ RBC kits used for nuclear medicine studies. METHODS: Non-heparinized blood (n = 15) and heparinized blood (n = 15) were added into UltraTag™ RBC kits. The samples were evaluated for macroscopic blood clots and microscopic platelet clumping. Control groups with heparin (n = 15) and control groups without heparin (n = 15) were used to help evaluate the effectiveness of the anticoagulant properties within the UltraTag™ RBC kits (sodium citrate) and to evaluate if that played a role in preventing blood clots/clumps...
September 15, 2016: Journal of Nuclear Medicine Technology
https://www.readbyqxmd.com/read/27623980/relevance-of-non-nutritional-calories-in-mechanically-ventilated-critically-ill-patients
#20
E Bousie, D van Blokland, H J W Lammers, A R H van Zanten
BACKGROUND/OBJECTIVES: Overfeeding in critically ill patients is associated with many complications. Propofol, dextrose infusion and citrate dialysis provide non-nutritional calories (NNCs), potentially causing overfeeding. The relevance of NNCs for total caloric intake has not been systematically studied. SUBJECTS/METHODS: We retrospectively studied adult mechanically ventilated intensive care unit (ICU) patients receiving enteral nutrition with or without supplemental parenteral nutrition...
September 14, 2016: European Journal of Clinical Nutrition
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