Outcomes of Continuous Renal Replacement Therapy With Regional Citrate Anticoagulation in Small Children After Cardiac Surgery: Experience and Protocol From a Single Center

被引：10

作者：

Musielak, Anna ^{[1
]}

Warzywoda, Alfred ^{[1
]}

Wojtalik, Michal ^{[1
]}

Kocinski, Bartlomiej ^{[1
]}

Kroll, Pawel ^{[1
]}

Ostalska-Nowicka, Danuta ^{[1
]}

Zachwieja, Jacek ^{[1
]}

机构：

[1] Poznan Univ Med Sci, Pediat Cardiol & Nephrol, Szpitalna 27-33, PL-60572 Poznan, Poland

来源：

THERAPEUTIC APHERESIS AND DIALYSIS | 2016年 / 20卷 / 06期

关键词：

Anticoagulation; Children; Citrate; Hemodiafiltration; Renal replacement therapy; CRITICALLY-ILL PATIENTS; CLEARANCE; CIRCUIT;

D O I：

10.1111/1744-9987.12456

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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 192h 40min with the circuit mean lifetime of 43h 33min. Clotting was found to be a cause of shutdown in 29% of circuits. No severe electrolyte and metabolic disorders were observed. The RCA-CRRT is a safe procedure for critically ill children with contraindications to the CRRT with heparin anticoagulation. To avoid adverse effects related to metabolic disorders a proper procedure protocol has to be followed.

引用

页码：639 / 644

页数：6

共 19 条

[1] Blood flow reductions during continuous renal replacement therapy and circuit life [J].

Baldwin, I ;

Bellomo, R ;

Koch, B .

INTENSIVE CARE MEDICINE, 2004, 30 (11) :2074-2079

[2] Citrate clearance in children receiving continuous venovenous renal replacement therapy [J].

Chadha, V ;

Garg, U ;

Warady, BA ;

Alon, US .

PEDIATRIC NEPHROLOGY, 2002, 17 (10) :819-824

[3] Citrate anticoagulation for continuous renal replacement therapy (CRRT) in patients with acute kidney injury admitted to the intensive care unit [J].

Davenport, Andrew ;

Tolwani, Ashita .

CLINICAL KIDNEY JOURNAL, 2009, 2 (06) :439-447

[4] Pediatric patients with multi-organ dysfunction syndrome receiving continuous renal replacement therapy [J].

Goldstein, SL ;

Somers, MJG ;

Baum, MA ;

Symons, JM ;

Brophy, PD ;

Blowey, D ;

Bunchman, TE ;

Baker, C ;

Mottes, T ;

McAfee, N ;

Barnett, J ;

Morrison, G ;

Rogers, K ;

Fortenberry, JD .

KIDNEY INTERNATIONAL, 2005, 67 (02) :653-658

[5] The effect of vascular access location and size on circuit survival in pediatric continuous renal replacement therapy: A report from the PPCRRT registry [J].

Hackbarth, R. ;

Bunchman, T. E. ;

Chua, A. N. ;

Somers, M. J. ;

Baum, M. A. ;

Symons, J. M. ;

Brophy, P. D. ;

Blowey, D. ;

Fortenberry, J. D. ;

Chand, D. ;

Flores, F. X. ;

Alexander, S. R. ;

Mahan, J. D. ;

Mcbryde, K. D. ;

Benfield, M. R. ;

Goldstein, S. L. .

INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS, 2007, 30 (12) :1116-1121

[6] Clinical review: Patency of the circuit in continuous renal replacement therapy [J].

Joannidis, Michael ;

Straaten, Heleen M. Oudemans-Van .

CRITICAL CARE, 2007, 11 (04)

[7] Citrate pharmacokinetics and metabolism in cirrhotic and noncirrhotic critically ill patients [J].

Kramer, L ;

Bauer, E ;

Joukhadar, C ;

Strobl, W ;

Gendo, A ;

Madl, C ;

Gangl, A .

CRITICAL CARE MEDICINE, 2003, 31 (10) :2450-2455

[8]

Kwiatkowski DM, 2015, ACUTE KIDNEY INJURY

[9] Incidence, risk factors, and outcomes of acute kidney injury after pediatric cardiac surgery: A prospective multicenter study [J].

Li, Simon ;

Krawczeski, Catherine D. ;

Zappitelli, Michael ;

Devarajan, Prasad ;

Thiessen-Philbrook, Heather ;

Coca, Steven G. ;

Kim, Richard W. ;

Parikh, Chirag R. .

CRITICAL CARE MEDICINE, 2011, 39 (06) :1493-1499

[10] Regional Citrate Anticoagulation for RRTs in Critically Ill Patients with AKI [J].

Morabito, Santo ;

Pistolesi, Valentina ;

Tritapepe, Luigi ;

Fiaccadori, Enrico .

CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2014, 9 (12) :2173-2188

← 1 2 →