In:
Blood Purification, S. Karger AG, Vol. 49, No. 1-2 ( 2020), p. 44-54
Abstract:
〈 b 〉 〈 i 〉 Purpose: 〈 /i 〉 〈 /b 〉 This study was aimed at evaluating the efficacy and safety of regional citrate anticoagulation (RCA) versus no-anticoagulation continuous venovenous hemofiltration (CVVH) in acute severe hypernatremia patients with increased bleeding risk. 〈 b 〉 〈 i 〉 Materials and Methods: 〈 /i 〉 〈 /b 〉 Acute severe hypernatremia patients with high bleeding risk who underwent CVVH in our center between January 2011 and October 2017 were considered as candidates. Patients who were & #x3c;18 years old, with hypovolemic hypernatremia, and had systemic anticoagulation were excluded. The included patients were divided into RCA and no-anticoagulation groups according to their anticoagulation strategy during CVVH and matched by age, sequential organ failure assessment scores, and vasopressor dependency. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Of the 64 included patients, no-anticoagulation and RCA were employed for CVVH in 23 and 41 patients, respectively. The serum sodium reduction rate (RRSeNa) was not significantly different between the no-anticoagulation and RCA groups ( 〈 i 〉 p 〈 /i 〉 = 0.729). Compared to no-anticoagulation, RCA significantly prolonged the circuit survival time (15 h [4.1–23.9] vs. 51 h [21.3–80.7] , 〈 i 〉 p 〈 /i 〉 = 0.001). The incidence of filter failure was 65.2% (15/23) in the no-anticoagulation group and 2.4% (1/41) in the RCA group ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001), respectively. In the matched cohort, the RRSeNas were not different between the 2 groups ( 〈 i 〉 p 〈 /i 〉 = 0.569), and the filter lifespan was significantly longer in the RCA group as well ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 RCA might be safe and effective for acute severe hypernatremia patients who underwent CVVH treatment. Further prospective, randomized, control trials are warranted to obtain robust evidences.
Type of Medium:
Online Resource
ISSN:
0253-5068
,
1421-9735
Language:
English
Publisher:
S. Karger AG
Publication Date:
2020
detail.hit.zdb_id:
605548-5
detail.hit.zdb_id:
1482025-0
