A Target-Oriented Algorithm for Citrate-Calcium Anticoagulation in Clinical Practice

作者：Strobl Karin^*; Hartmann Jens; Wallner Manfred; Brandl Martin; Falkenhagen Dieter

来源：Blood Purification, 2013, 36(2): 136-145.

DOI：10.1159/000355012

• Anticoagulation
• Blood purification
• Clinical study
• Extracorporeal therapies
• Haemodialysis
• Regional citrate anticoagulation

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 (Ca2+) 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 Ca2+ pre-filter using the target-oriented algorithm, the degree of anticoagulation may be easily controlled.

• 出版日期2013