Regional citrate anticoagulation in critically ill patients treated with plasma filtration and adsorption.

Long-term continuous renal replacement therapy and anticoagulation with citrate in critically ill patients with severe liver dysfunction

BACKGROUND As of 2009, anticoagulation with citrate was standard practice in continuous renal replacement therapy (CRRT) for critically ill patients at the University Medical Centre of Saarland, Germany. Partial hepatic metabolism of citrate means accumulation may occur during CRRT in critically ill patients with impaired liver function. The aim of this study was to evaluate the actual influenc...

Incidence and outcome of citrate accumulation in critically ill patients undergoing continuous renal replacement therapy with regional citrate anticoagulation

Regional citrate anticoagulation in continuous venovenous hemofiltration in critically ill patients with a high risk of bleeding.

BACKGROUND Systemic heparinization is associated with a high rate of bleeding when used to maintain patency of the extracorporeal circuit during continuous renal replacement therapy (CRRT) in critically ill patients. Regional anticoagulation can be achieved with citrate, but previously described techniques are cumbersome and associated with metabolic complications. METHODS We designed a simpl...

Citrate anticoagulation versus systemic heparinisation in continuous venovenous haemofiltration in critically ill patients with acute kidney injury: a multi-center randomized clinical trial

Introduction: Because of ongoing controversy, renal and vital outcomes are compared between systemically administered unfractionated heparin and regional anticoagulation with citrate-buffered replacement solution in predilution mode, during continuous venovenous haemofiltration (CVVH) in critically ill patients with acute kidney injury (AKI). Methods: In this multi-center randomized controlled ...

Total-to-ionized calcium ratio predicts mortality in continuous renal replacement therapy with citrate anticoagulation in critically ill patients

INTRODUCTION Regional citrate anticoagulation is safe, feasible and increasingly used in critically ill patients on continuous renal replacement therapy (CRRT). However, in patients with hepatic or multi-organ dysfunction, citrate accumulation may lead to an imbalance of calcium homeostasis. The study aimed at evaluating the incidence and prognostic relevance of an increased total to ionized ca...