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Unapparent systemic effects of regional anticoagulation with citrate in continuous renal replacement therapy a narrative review

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Main Authors: Willem, Boer, Walter, Verbrugghe, Eric, Hoste
Format: Book
Language:English
Published: Springer 2023
Subjects:
regional anticoagulation
narrative review
Online Access:https://link.springer.com/article/10.1186/s13613-023-01113-0
https://dlib.phenikaa-uni.edu.vn/handle/PNK/6916
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spelling oai:localhost:PNK-69162023-03-16T07:06:13Z Unapparent systemic effects of regional anticoagulation with citrate in continuous renal replacement therapy a narrative review Willem, Boer Walter, Verbrugghe Eric, Hoste regional anticoagulation narrative review CC BY After citrate administration, calcium citrate complexes are formed. Clearance in diffusive modes increases with the dialysate flow, in convective modes with filtration flow [12]. Complexes that are not removed through the hemofilter return to the patient. In convective modes up to 60% of the citrate given prefilter is cleared via the hemofilter into the effluent (sometimes more in diffusive modes), the rest returning to the patient for metabolization [12]. Decreasing blood flow limits the amount of delivered citrate to the extracorporeal circuit. Limiting blood flows in convective modes in combination with high filtration rates may lead to a high filtration fraction. Therefore, higher blood flows resulting in a higher delivered citrate dose may be necessary in convective modes, compared to diffusive modes, to achieve similar levels of clearance [4]. The Kidney Disease Improving Global Outcomes guidelines recommend targeting an effluent flow of 20–25 ml/kg/h [1]. Before the blood from the circuit is returned to the patient, calcium is added to normalize iCa and coagulation. Numerous protocols for regional citrate anticoagulation are available, utilizing different citrate solutions and CRRT modalities (continuous veno-venous hemofiltration (CVVH), continuous veno-venous hemodialysis (CVVHD), continuous veno-venous hemodiafiltration (CVVHDF)[4]. 2023-03-16T04:17:34Z 2023-03-16T04:17:34Z 2023 Book https://link.springer.com/article/10.1186/s13613-023-01113-0 https://dlib.phenikaa-uni.edu.vn/handle/PNK/6916 en application/pdf Springer
institution Digital Phenikaa
collection Digital Phenikaa
language English
topic regional anticoagulation
narrative review
spellingShingle regional anticoagulation
narrative review
Willem, Boer
Walter, Verbrugghe
Eric, Hoste
Unapparent systemic effects of regional anticoagulation with citrate in continuous renal replacement therapy a narrative review
description CC BY
format Book
author Willem, Boer
Walter, Verbrugghe
Eric, Hoste
author_facet Willem, Boer
Walter, Verbrugghe
Eric, Hoste
author_sort Willem, Boer
title Unapparent systemic effects of regional anticoagulation with citrate in continuous renal replacement therapy a narrative review
title_short Unapparent systemic effects of regional anticoagulation with citrate in continuous renal replacement therapy a narrative review
title_full Unapparent systemic effects of regional anticoagulation with citrate in continuous renal replacement therapy a narrative review
title_fullStr Unapparent systemic effects of regional anticoagulation with citrate in continuous renal replacement therapy a narrative review
title_full_unstemmed Unapparent systemic effects of regional anticoagulation with citrate in continuous renal replacement therapy a narrative review
title_sort unapparent systemic effects of regional anticoagulation with citrate in continuous renal replacement therapy a narrative review
publisher Springer
publishDate 2023
url https://link.springer.com/article/10.1186/s13613-023-01113-0
https://dlib.phenikaa-uni.edu.vn/handle/PNK/6916
_version_ 1760553558845947904
score 8.891145

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