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Blood Purif. 2013;36(2):136-45. doi: 10.1159/000355012. Epub 2013 Nov 7.

A target-oriented algorithm for citrate-calcium anticoagulation in clinical practice.

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1
Center for Biomedical Technology, Danube University Krems, Krems, Austria.

Abstract

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 (Ca(2+)) 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 Ca(2+) pre-filter using the target-oriented algorithm, the degree of anticoagulation may be easily controlled.

PMID:
24217288
DOI:
10.1159/000355012
[Indexed for MEDLINE]

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