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Treatment Effect of Regional Sodium Citrate Anticoagulation in Elderly Patients With High-Risk Bleeding Receiving Continuous Renal Replacement Therapy

OBJECTIVE: To investigate the safety and efficacy of regional citrate anticoagulation (RCA) on elderly patients at high risk of bleeding after continuous renal replacement therapy (CRRT). METHODS: A total of 31 patients at high risk of bleeding who received CRRT in the intensive care unit were colle...

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Autores principales: Xun, Kang, Qiu, Hong, Jia, Miao, Lin, Lihua, He, Meiling, Li, Damei, Jin, Donghua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8559185/
https://www.ncbi.nlm.nih.gov/pubmed/34719982
http://dx.doi.org/10.1177/10760296211050640
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author Xun, Kang
Qiu, Hong
Jia, Miao
Lin, Lihua
He, Meiling
Li, Damei
Jin, Donghua
author_facet Xun, Kang
Qiu, Hong
Jia, Miao
Lin, Lihua
He, Meiling
Li, Damei
Jin, Donghua
author_sort Xun, Kang
collection PubMed
description OBJECTIVE: To investigate the safety and efficacy of regional citrate anticoagulation (RCA) on elderly patients at high risk of bleeding after continuous renal replacement therapy (CRRT). METHODS: A total of 31 patients at high risk of bleeding who received CRRT in the intensive care unit were collected. The patients were divided into RCA group (n = 17) and no anticoagulation group (NA, n = 14) according to whether RCA was used or not. The levels of creatinine (Cr), blood urea nitrogen (BUN), prothrombin time (PT), activated partial thromboplastin time (APTT), total calcium (tCa), ionized calcium ion (iCa(2+)), sodium ion (Na(+)), bicarbonate ion (HCO(3)(−)), tCa/iCa(2+) ratio, and pH were observed after treatment. The filter use time, number of filters used, filter obstruction events, clinical outcomes, and safety evaluation indexes were compared post-treatment. RESULTS: After treatment, serum Cr and BUN levels, APTT and PT levels in the RCA group were significantly lower than the NA group. The tCa, iCa(2+), HCO(3)(−), tCa/iCa(2+), and pH were within the normal range after RCA treatment while Na(+) levels saw a significant increase. In the RCA group, the filter using time was significantly longer, with significantly reduced numbers of filter use within 72 h and filter disorder events. Additionally, patients in the RCA group showed significant recovery of renal function and a significant reduction in bleeding events and in-hospital mortality. CONCLUSION: RCA treatment significantly improves clinical outcome of patients at high risk of bleeding after CRRT, safely and effectively prolongs the filter life and avoids coagulation incidences.
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spelling pubmed-85591852021-11-02 Treatment Effect of Regional Sodium Citrate Anticoagulation in Elderly Patients With High-Risk Bleeding Receiving Continuous Renal Replacement Therapy Xun, Kang Qiu, Hong Jia, Miao Lin, Lihua He, Meiling Li, Damei Jin, Donghua Clin Appl Thromb Hemost Original Manuscript OBJECTIVE: To investigate the safety and efficacy of regional citrate anticoagulation (RCA) on elderly patients at high risk of bleeding after continuous renal replacement therapy (CRRT). METHODS: A total of 31 patients at high risk of bleeding who received CRRT in the intensive care unit were collected. The patients were divided into RCA group (n = 17) and no anticoagulation group (NA, n = 14) according to whether RCA was used or not. The levels of creatinine (Cr), blood urea nitrogen (BUN), prothrombin time (PT), activated partial thromboplastin time (APTT), total calcium (tCa), ionized calcium ion (iCa(2+)), sodium ion (Na(+)), bicarbonate ion (HCO(3)(−)), tCa/iCa(2+) ratio, and pH were observed after treatment. The filter use time, number of filters used, filter obstruction events, clinical outcomes, and safety evaluation indexes were compared post-treatment. RESULTS: After treatment, serum Cr and BUN levels, APTT and PT levels in the RCA group were significantly lower than the NA group. The tCa, iCa(2+), HCO(3)(−), tCa/iCa(2+), and pH were within the normal range after RCA treatment while Na(+) levels saw a significant increase. In the RCA group, the filter using time was significantly longer, with significantly reduced numbers of filter use within 72 h and filter disorder events. Additionally, patients in the RCA group showed significant recovery of renal function and a significant reduction in bleeding events and in-hospital mortality. CONCLUSION: RCA treatment significantly improves clinical outcome of patients at high risk of bleeding after CRRT, safely and effectively prolongs the filter life and avoids coagulation incidences. SAGE Publications 2021-10-30 /pmc/articles/PMC8559185/ /pubmed/34719982 http://dx.doi.org/10.1177/10760296211050640 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Manuscript
Xun, Kang
Qiu, Hong
Jia, Miao
Lin, Lihua
He, Meiling
Li, Damei
Jin, Donghua
Treatment Effect of Regional Sodium Citrate Anticoagulation in Elderly Patients With High-Risk Bleeding Receiving Continuous Renal Replacement Therapy
title Treatment Effect of Regional Sodium Citrate Anticoagulation in Elderly Patients With High-Risk Bleeding Receiving Continuous Renal Replacement Therapy
title_full Treatment Effect of Regional Sodium Citrate Anticoagulation in Elderly Patients With High-Risk Bleeding Receiving Continuous Renal Replacement Therapy
title_fullStr Treatment Effect of Regional Sodium Citrate Anticoagulation in Elderly Patients With High-Risk Bleeding Receiving Continuous Renal Replacement Therapy
title_full_unstemmed Treatment Effect of Regional Sodium Citrate Anticoagulation in Elderly Patients With High-Risk Bleeding Receiving Continuous Renal Replacement Therapy
title_short Treatment Effect of Regional Sodium Citrate Anticoagulation in Elderly Patients With High-Risk Bleeding Receiving Continuous Renal Replacement Therapy
title_sort treatment effect of regional sodium citrate anticoagulation in elderly patients with high-risk bleeding receiving continuous renal replacement therapy
topic Original Manuscript
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8559185/
https://www.ncbi.nlm.nih.gov/pubmed/34719982
http://dx.doi.org/10.1177/10760296211050640
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