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Blood Purif. 2012;33(1-3):7-20. doi: 10.1159/000332394. Epub 2011 Nov 11.

A target-orientated algorithm for regional citrate-calcium anticoagulation in extracorporeal therapies.

Author information

1
Center for Biomedical Technology, Danube University Krems, Krems, Austria. martin.brandl @ donau-uni.ac.at

Abstract

BACKGROUND:

Citrate anticoagulation offers several advantages in comparison to conventional anticoagulation. Most algorithms for regional citrate-calcium anticoagulation are based on citrate and calcium chloride infusion coupled in a fixed proportion to the blood flow without considering the hematocrit (Hct)/plasma flow or the filter clearance of citrate and calcium.

METHODS:

The aim of this study was to develop an algorithm for optimized citrate anticoagulation in extracorporeal therapies such as dialysis. A mathematical model was developed to calculate the volume of citrate infusion required to achieve a desired ionized calcium (iCa) target level in the extracorporeal circuit and to restore the total calcium level to a physiological value.

RESULTS:

The model was validated by correlation analyses for different blood Hct values and shows an excellent fit to the laboratory measurements.

CONCLUSION:

The results for both iCa target concentrations, namely those after citrate and calcium infusion, proved that the software algorithm adapts well to variable treatment parameters.

PMID:
22085810
DOI:
10.1159/000332394
[Indexed for MEDLINE]

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