Delay in onset of metabolic alkalosis during regional citrate anti-coagulation in continous renal replacement therapy with calcium-free replacement solution.
Ann Card Anaesth
;
2009 Jul; 12(2): 122-126
Article
in English
| IMSEAR
| ID: sea-135165
ABSTRACT
Regional citrate anti-coagulation for continuous renal replacement therapy chelates calcium to produce the anti- coagulation effect. We hypothesise that a calcium-free replacement solution will require less citrate and produce fewer metabolic side effects. Fifty patients, in a Medical Intensive Care Unit of a tertiary teaching hospital (25 in each group), received continuous venovenous hemofiltration using either calcium-containing or calcium-free replacement solutions. Both groups had no significant differences in filter life, metabolic alkalosis, hypernatremia, hypocalcemia, and hypercalcemia. However, patients using calcium-containing solution developed metabolic alkalosis earlier, compared to patients using calcium-free solution (mean 24.6 hours,CI 0.8-48.4 vs. 37.2 hours, CI 9.4-65, P = 0.020). When calcium-containing replacement solution was used, more citrate was required (mean 280ml/h, CI 227.2-332.8 vs. 265ml/h, CI 203.4-326.6, P = 0.069), but less calcium was infused (mean 21.2 ml/h, CI 1.2-21.2 vs 51.6ml/h, CI 26.8-76.4, P ≤ 0.0001).
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Aged
/
Female
/
Humans
/
Male
/
Hemodialysis Solutions
/
Calcium
/
Retrospective Studies
/
Hemofiltration
/
Renal Replacement Therapy
/
Alkalosis
Type of study:
Observational study
Language:
English
Journal:
Ann Card Anaesth
Year:
2009
Type:
Article
Similar
MEDLINE
...
LILACS
LIS