Key result
A new target-oriented algorithm for regional citrate anticoagulation achieved mean pre-filter ionized calcium values of 0.23 and 0.33 mmol/l in the 0.2 and 0.3 mmol/l target groups, respectively.
Why the study?
Does a semi-automated target-oriented algorithm for regional citrate anticoagulation provide safe and functional anticoagulation in haemodialysis patients?
Does a semi-automated target-oriented algorithm for regional citrate anticoagulation provide safe and functional anticoagulation in haemodialysis patients?
A new semi-automated target-oriented algorithm for regional citrate anticoagulation in hemodialysis appears safe and accurate, effectively controlling anticoagulation without citrate accumulation.
Answers are grounded in this paper and cite their sources.
Supports feasibility of target-oriented citrate anticoagulation in hemodialysis; case report leaves open need for randomized validation.
BACKGROUND/AIMS: Because of a high monitoring demand and an ensuing need for automation of regional citrate anticoagulation (RCA), a new semi-automated target-oriented algorithm was developed. The aim of this study was the evaluation of its functionality and safety. METHODS: Fourteen haemodialysis patients were treated 5 times consecutively with RCA. Samples were drawn pre- and post-infusion once per hour. Electrolytes, blood cell counts, acid-base and coagulation parameters were analyzed. RESULTS: Mean ionized calcium (Ca(2+)) values pre-filter were 0.23 and 0.33 mmol/l in the 0.2 and 0.3 mmol/l target groups, respectively. Extraction ratios for citrate and total calcium through the dialysis filter were constant during the entire treatment (83 and 68%, respectively). Citrate accumulation was avoided. CONCLUSION: The new algorithm enables safe and accurate RCA. By regulating Ca(2+) pre-filter using the target-oriented algorithm, the degree of anticoagulation may be easily controlled.
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Strobl et al. (2013) studied Haemodialysis (n=14). Semi-automated target-oriented algorithm for regional citrate anticoagulation was evaluated on Functionality and safety (mean ionized calcium values pre-filter). A new target-oriented algorithm for regional citrate anticoagulation achieved mean pre-filter ionized calcium values of 0.23 and 0.33 mmol/l in the 0.2 and 0.3 mmol/l target groups, respectively.
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