In:
Blood Purification, S. Karger AG, Vol. 33, No. 1-3 ( 2012), p. 80-87
Abstract:
〈 i 〉 Background: 〈 /i 〉 There are limited data on systemic delivery of metabolic substrates during citrate anticoagulation. The direct citrate measurements are usually not available. 〈 i 〉 Methods: 〈 /i 〉 Patients on 2.2% acid-citrate-dextrose (ACD, n = 41) were compared to a control group on unfractionated heparin (n = 17). All were treated on 1.9-m 〈 sup 〉 2 〈 /sup 〉 polysulfone filters. Samples were taken from the central venous catheter, ports pre- and post-filter and from effluent. 〈 i 〉 Results: 〈 /i 〉 The gain of citrate in CVVH (n = 18) was not different from CVVHDF (n = 23, p = 0.8). Mean gain of citrate was 25.4 ± 6.4 mmol/h. The systemic loads of lactate (p = 0.12) and glucose (p = 0.23) in CVVH were similar to CVVHDF. Mean inputs of lactate and glucose were 62.9 ± 21.1 and 26.6 ± 10.4 mmol/h, respectively. The mean difference between post- and prefilter unmeasured anions (d-UA) correlated with mean difference of citrate concentrations (p 〈 0.0001, r 〈 sup 〉 2 〈 /sup 〉 = 0.66). The estimated caloric load of the citrate modalities was 5,536 ± 1,385 kJ/ 24 h. 〈 i 〉 Conclusions: 〈 /i 〉 ACD might represent a significant load of metabolic substrates, particularly if used with lactate buffer. Systemic delivery of citrate can be predicted using d-UA in the extracorporeal circuit.
Type of Medium:
Online Resource
ISSN:
0253-5068
,
1421-9735
Language:
English
Publisher:
S. Karger AG
Publication Date:
2012
detail.hit.zdb_id:
1482025-0
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