Role of local citrate anticoagulation in continuous blood purification to patients at high risk of bleeding in ICU.
10.11817/j.issn.1672-7347.2016.12.014
- Author:
Shangping ZHAO
1
;
Hao OU
1
;
Yue PENG
1
;
Zuoliang LIU
1
;
Mingshi YANG
1
;
Xuefei XIAO
1
Author Information
1. (Center of Critical Care Medicine, Third Xiangya Hospital, Central South University, Changsha 410013, China.
- Publication Type:Clinical Trial
- MeSH:
Anticoagulants;
pharmacology;
Bicarbonates;
blood;
Blood Coagulation;
drug effects;
Blood Coagulation Tests;
Calcium;
blood;
Citrates;
Citric Acid;
therapeutic use;
Female;
Hemodiafiltration;
adverse effects;
methods;
Hemofiltration;
Hemorrhage;
etiology;
prevention & control;
Heparin;
therapeutic use;
Humans;
Intensive Care Units;
Male;
Reference Values;
Renal Dialysis;
Sodium;
blood;
Treatment Outcome
- From:
Journal of Central South University(Medical Sciences)
2016;41(12):1334-1339
- CountryChina
- Language:Chinese
-
Abstract:
To evaluate the safety and efficiency of citrate anticoagulant-based continuous blood purification in patients at high risk of bleeding.
Methods: One hundred and fifty-two patients at high risk of bleeding were divided into local citrate group (group A, n=68) and heparin group (group B, n=84). Clotting function, change of pH, ionized sodium, bicarbonate ion, ionized calcium, activated clotting time (ACT) and complications were monitored before and during treatment.
Results: Compared to the group A, the incidence of clotting in filter and chamber, the degree of bleeding or fresh bleeding were significantly reduced in the group B (P<0.05). ACT of post-filter at 4, 8 and 12 h during the treatment in the group A was significantly extended compared with that without treatment (P<0.05), while there was no significant change in group B (P>0.05). The pH value, the levels of ionized sodium, bicarbonate ion and ionized calcium during the treatment were maintained in normal range in both group A and group B.
Conclusion: Local citrate-based continuous blood purification can achieve effective anticoagulation and decrease the incidence of bleeding. It is an ideal choice for patients at high risk of bleeding.
