Details

Autor(en) / Beteiligte

• Degraeve, Anais
• Danse, Etienne
• Laterre, Pierre-François
• Hantson, Philippe
• Werion, Alexis

Titel

Regional citrate anticoagulation and influence of recirculation on ionized calcium levels in the circuit

Ist Teil von

• Journal of artificial organs, 2019-12, Vol.22 (4), p.341-344

Ort / Verlag

Tokyo: Springer Japan

Erscheinungsjahr

2019

Quelle

MEDLINE

Beschreibungen/Notizen

• Regional citrate anticoagulation is now widely used during continuous renal replacement therapy (CRRT), and especially in patients at risk for hemorrhagic complications. A close monitoring is required to avoid citrate overload, leading to metabolic alkalosis or citrate intoxication causing metabolic acidosis. This case report describes a dysfunction of the regional citrate anticoagulation due to the development of a deep vein thrombosis close to the site of insertion of the venous CRRT catheter. The result was a local recirculation in the circuit with a local citrate overload (acidosis and non-measurable calcium). In the patient’s blood samples, the [calcium total /Ca 2+ systemic ] ratio remained normal as a proof of local citrate accumulation without systemic effects. Initially, CRRT remained effective, but due to the progressive decrease of serum creatinine and cystatin C clearance, the site of catheter insertion was changed.