Advances in Continuous Renal Replacement Therapy: Citrate Anticoagulation Update

被引：60
作者：
Tolwani, Ashita [1 ]
Wille, Keith M. [1 ]
机构：
[1] Univ Alabama Birmingham, Birmingham, AL 35294 USA
来源：
BLOOD PURIFICATION | 2012年 / 34卷 / 02期
关键词：
Continuous renal replacement therapy; Regional citrate anticoagulation; Heparin-induced thrombocytopenia; CRITICALLY-ILL PATIENTS; CONTINUOUS VENOVENOUS HEMOFILTRATION; REGIONAL CITRATE; HEPARIN ANTICOAGULATION; SYSTEMIC HEPARIN; HEMODIALYSIS; EFFICACY; SAFETY; PROTOCOL; RISK;
D O I：
10.1159/000342378
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
Because of the potential side effects of heparin, methods of regional citrate anticoagulation (RCA) for continuous renal replacement therapy (CRRT) have been gaining wider acceptance with the development of simplified and safer protocols. Advantages of RCA include the avoidance of systemic anticoagulation and heparin-induced thrombocytopenia. The disadvantage is that citrate can add complexity and labor intensity to CRRT. Frequent monitoring of electrolytes, ionized calcium, and acid-base status is required, due to the potential for hypernatremia, metabolic alkalosis, and systemic ionized hypocalcemia. If properly monitored, complications associated with RCA are uncommon. A variety of methods of delivering RCA are described in the literature. Overall, studies of RCA, as compared to unfractionated heparin, report better filter survival times and less bleeding. In this section, we summarize the characteristics of citrate as an anticoagulant and provide an update of citrate use in CRRT. Copyright (c) 2012 S. Karger AG, Basel
引用
收藏
页码：88 / 93
页数：6
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