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  4. Automated regional citrate anticoagulation: Technological barriers and possible solutions

Automated regional citrate anticoagulation: Technological barriers and possible solutions

Balazs Szamosfalvi
Stanley Frinak
Jerry Yee

01-01-2010

Background: Large-scale adoption of regional citrate anticoagulation (RCA) is prevented by risks of the technique as practiced traditionally. Safe RCA protocols with automated delivery on customized d..

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Background: Large-scale adoption of regional citrate anticoagulation (RCA) is prevented by risks of the technique as practiced traditionally. Safe RCA protocols with automated delivery on customized dialysis systems are needed. Methods: We applied kinetic analysis of solute fluxes during RCA to design a protocol for sustained low-efficiency dialysis (SLED) for critically ill patients. We used a high-flux hemodialyzer, a zero-calcium (Ca) dialysate, a dialysis machine with online clearance and access recirculation monitoring, and a separate optical hematocrit (Hct) sensor. Flow rates were QB = 200 ml/min for blood; QD = 400 ml/min for dialysate, with Na = 140 mmol/l and HCO3 = 32 mmol/l; Qcitrate = 400 ml/h of acid citrate dextrose A; ultrafiltration as indicated. The QCa was infused into the return blood line, adjusted hourly based on online Hct and a 1 mmol/l in the blood reservoir and

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Article

https://scholarlycommons.henryford.com/context/nephrology_articles/article/1254/viewcontent

http://scholarlycommons.henryford.com/nephrology_articles/254

20093828

http://sfxhosted.exlibrisgroup.com/hfhs?sid=Entrez:PubMed&id=pmid:20093828

Blood Purification

29

http://sfxhosted.exlibrisgroup.com/hfhs?sid=Entrez:PubMed&id=pmid:20093828

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