A calcium-containing replacement solution simplified regional citrate anticoagulation in continuous venovenous hemofiltration for children after congenital heart surgery
10.3760/cma.j.issn.1673-4912.2019.03.008
- VernacularTitle:含钙置换液简化先天性心脏病术后儿童血液滤过枸橼酸抗凝模式研究
- Author:
Jihong HUANG
1
;
Zhuoming XU
;
Xiaolei GONG
;
Zhihao LI
Author Information
1. 上海交通大学医学院附属上海儿童医学中心心胸外科 200127
- Keywords:
Regional citrate anticoagulant;
Calcium-containing replacement solution;
Continuous veno-venous hemofiltration;
Congenital heart disease
- From:
Chinese Pediatric Emergency Medicine
2019;26(3):195-200
- CountryChina
- Language:Chinese
-
Abstract:
Objective To simplify regional citrate anticoagulation(RCA) in continuous veno-venous hemofiltration (CVVH) with a calcium-containing replacement solution for children after congenital heart surgery.Methods The clinical data of 20 children with RCA in CVVH after congenital heart surgery were retrospectively analyzed.All cases were divided into two groups:the traditional group(12 cases) using a calcium-free replacement solution and the modified group(8 cases) using a calcium-containing replacement solution.The blood gas data,plasma ionic calcium,total calcium/ionic calcium ratio,circuit survival time,calcium supplement and the number of adjustments of replacement fluid formula were compared between the two groups after CVVH.Results During RCA-CVVH,serum HCO3-,pH,systemic ionized calcium,and the ratio of total calcium / ionic calcium were higher than those before RCA-CVVH,but all in normal range.There was no significant difference in circuit survival time between two groups [(50.5 ± 2.3) h vs.(48.8 ± 4.7)h,respectively,P ＞0.05].Calcium supplementation in the traditional group was significantly higher than that in the modified group[2.5％ calcium chloride supplementation was(0.43 ±0.11) ml/(kg-h) in the traditional group and(0.13 ± 0.17) ml/(kg-h) in the modified group].The number of replacement solution adjustment was (2.7 ± 1.1) times in traditional group,while the modified group did not change the replacement formula.Conclusion RCA using a calcium-containing replacement fluid in hemofiltration,can reduce the supplement of calcium and the times of the replacement solution adjustment,which is easy to operate.It can be used safely,effectively and conveniently in CVVH children after congenital heart surgery.
