Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
4
pubmed:dateCreated
2007-11-20
pubmed:abstractText
Different methods of regional anticoagulation using citrate in continuous renal replacement therapy have been described in the past. However, these procedures were usually very complex or did not reach modem requirements for effective continuous renal replacement therapy. Furthermore, little is known about long-term acid-base stability and citrate levels during the treatment. We describe a system in which citrate is used both as anticoagulant and as the sole buffer substance in continuous venovenous haemofiltration. Our citrate-containing, calcium-free substitution fluid was used in predilution mode with a constant ratio between blood flow (120 to 150 ml/min) and substitution flow (2400 to 3000 ml/hour). Anticoagulation was limited to the extracorporeal circuit. Twenty patients with acute renal failure on mechanical ventilation were treated, four for eight hours, four for 24 hours and 12 as long they needed continuous renal replacement therapy (9.6 +/- 5.0 days, range 4.0 to 39.3 days). We achieved stable acid-base and electrolyte balance in all patients. We observed no bleeding complications (patient activated clotting time 112.4 +/- 17.1 s, post-filter circuit activated clotting time 270.5 +/- 80.3 s) and achieved appropriate filter life times (48.6 +/- 13.2 h). Predilution, citrate-based substitution fluid provides both anticoagulation within the extracorporeal circuit and control of acid-base balance in critically ill patients at risk of bleeding in acute renal failure. It is easy to apply and safe. Clearance can be varied as long as a constant ratio between blood and substitution flow is maintained.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Aug
pubmed:issn
0310-057X
pubmed:author
pubmed:issnType
Print
pubmed:volume
35
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
529-35
pubmed:dateRevised
2010-11-18
pubmed:meshHeading
pubmed-meshheading:18020071-Acid-Base Equilibrium, pubmed-meshheading:18020071-Acute Kidney Injury, pubmed-meshheading:18020071-Adult, pubmed-meshheading:18020071-Aged, pubmed-meshheading:18020071-Aged, 80 and over, pubmed-meshheading:18020071-Anticoagulants, pubmed-meshheading:18020071-Buffers, pubmed-meshheading:18020071-Calcium, pubmed-meshheading:18020071-Citric Acid, pubmed-meshheading:18020071-Creatinine, pubmed-meshheading:18020071-Female, pubmed-meshheading:18020071-Hemodialysis Solutions, pubmed-meshheading:18020071-Hemofiltration, pubmed-meshheading:18020071-Humans, pubmed-meshheading:18020071-Hydrogen-Ion Concentration, pubmed-meshheading:18020071-Intensive Care Units, pubmed-meshheading:18020071-Male, pubmed-meshheading:18020071-Middle Aged, pubmed-meshheading:18020071-Renal Replacement Therapy, pubmed-meshheading:18020071-Time Factors, pubmed-meshheading:18020071-Urea
pubmed:year
2007
pubmed:articleTitle
Continuous venovenous haemofiltration using a citrate buffered substitution fluid.
pubmed:affiliation
Clinic for Nephrology, University Hospital, Düsseldorf, Germany.
pubmed:publicationType
Journal Article