The application of regional citrate anti-coagulation for continuous veno-venous hemofiltration in severe trauma patients
10.3969/j.issn.1008-9691.2016.03.021
- VernacularTitle:局部枸橼酸抗凝在重症创伤患者连续性静脉-静脉血液滤过中的应用
- Author:
Zixia WU
1
;
En MU
;
Xin WENG
;
Zhonghui ZHANG
;
Zhiyong LIU
;
Zhenming ZHANG
;
Jian WANG
;
Yi LIU
;
Wei ZHANG
;
Jin LU
Author Information
1. 天津市天津医院重症医学科,天津300211
- Keywords:
Regional citrate anticoagulation;
Continuous renal replacement therapy;
Severe trauma
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2016;23(3):307-309
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the efficacy and safety of regional citrate anticoagulation (RCA) for continuous veno-venous hemofiltration (CVVH) in patients with severe trauma.Methods Sixty-four patients with severe trauma who needed to apply continuous renal replacement therapy (CRRT) and were admitted into the department of critical care medicine in Tianjin Hospital from June 2013 to August 2015 were enrolled in the study.According to the patient's actual condition,they were divided into two groups:no anticoagulant group (29 cases) and RCA group (35 cases).The filter lifetime,after treatment the activated partial thromboplastin time (APTT),acid-base balance,free calcium ([Ca2+]i) and serum sodium (Na+) concentrations,bleeding episodes were compared between the two groups.Results The average filter lifetime in RCA group was longer than that in no anticoagulant group (hours:50.7 ± 11.3 vs.4.9 ± 1.2,P ＜ 0.01).After the end of treatment,the levels of APTT (s:30.7 ± 8.8 vs.32.1 ± 7.3),pH value (7.41 ± 0.09 vs.7.40 ± 0.07),[Ca2+]i (mmol/L:2.13 ± 0.20 vs.2.21 ± 0.17),and Na+ (mmol/L:139 ± 8 vs.141 ± 6) were ofno significant differences between the RCA group and the no anticoagulant group (all P ＞ 0.05).The incidence of clinicalbleeding in RCA group was lower than that in no anticoagulant group [2.9％ (1/35) vs.13.8％ (4/29)],but the differencewas not statistically significant (P ＞ 0.05).Conclusions RCA-CVVH is a safe and effective therapeutic method inpatients with severe trauma who need for CRRT,the stability of internal environment is not affected and no incidence ofclinical bleeding event is increased.
