Sensors and hybrid therapies: A new approach with automated citrate anticoagulation

Document Type

Article

Publication Date

10-1-2012

Publication Title

Blood Purification

Abstract

Background: Hybrid therapies use intermittent hemodialysis (IHD) machines adapted to provide prolonged intermittent or continuous renal replacement therapy in the intensive care unit (ICU). Despite the low cost, hybrid therapy use is limited warranting a novel approach. Methods: The literature was reviewed for limitations of hybrid protocols, use of regional citrate anticoagulation (RCA) on hybrid systems and sensors for IHD and hybrid therapy. The novel hybrid program in the authors' institution is presented as a plausible future direction for the modality. Results: Hybrid therapies are limited by access flow and clotting alarms. Technology limitations render many IHD sensors inoperable at low dialysate flow. A synergy with RCA allows a novel, safe approach with low blood flows and high dialysate flows with alarm- and clotting-free operation and all commercial IHD sensors functional. Conclusion: The low cost, ease of use, safety and efficacy of hybrid therapy with near-automated RCA may lead to rapid expansion of this form of ICU renal support. Copyright © 2012 S. Karger AG, Basel.

PubMed ID

23095406

Volume

34

Issue

2

First Page

80

Last Page

87

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