Observation on the application effect of local citrate anticoagulation in CRRT tandem artificial liver treat-ment
10.3969/j.issn.1006-5725.2024.13.020
- VernacularTitle:局部枸橼酸抗凝在连续肾脏替代疗法串联人工肝治疗中的运用效果观察
- Author:
Yufeng JIN
1
;
Cunyi SHEN
;
Jingyao ZHANG
;
Yulong XUE
;
Dong HE
Author Information
1. 西安交通大学第一附属医院(西安 710061)
- Keywords:
acute on chronic liver failure;
acute kidney injury;
citric acid;
artificial liver;
CRRT
- From:
The Journal of Practical Medicine
2024;40(13):1879-1884
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the effectiveness and safety of Regional Citrate Anticoagulation(RCA)in CRRT combined with artificial liver treatment.Methods Clinical data of 54 sessions of CRRT linked with artificial liver treatment using RCA in 21 patients with acute on chronic liver failure(ACLF)combined with acute kidney injury(AKI)admitted to our center from December 2019 to June 2023 were collected..The improvement of liver and kidney function indicators,anticoagulant effect and adverse reactions of citric acid,and patient outcomes were observed and analyzed before and after treatment.Results The 54 cases of liver and renal function indexes were improved,which showed a statistically significant difference(P<0.05);All 54 cases of CRRT linked artificial liver treatment were successfully completed,and no obvious blood clots were found in the extracorporeal circulation tubing,filters,and adsorbers;There was no statistically significant difference(P>0.05)in the total calcium and ionized calcium levels of all patients at each stage of artificial liver treatment compared to before treatment;However,three cases of CRRT combined with PE and one case of CRRT combined with DPMAS+LPE experienced citrate accumulation after treatment,which returned to normal after 24 hours of timely correction and supplemen-tation;The 30-day survival rate of the 21 patients was 13 survivors,5 deaths,and 3 discharged automatically.Conclusion Under strict monitoring and timely adjustment,the application of RCA in CRRT series artificial liver treatment is safe and feasible,and is worthy of clinical promotion.
