Journal of artificial organs, 2019-12, Vol.22 (4), p.341-344
2019
Volltextzugriff (PDF)
Details
- Autor(en) / Beteiligte
- 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
- SpringerLink Journals
- 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.
- Sprache
- Englisch
- Identifikatoren
- ISSN: 1434-7229eISSN: 1619-0904DOI: 10.1007/s10047-019-01125-3Titel-ID: cdi_proquest_miscellaneous_2315969822
- Format
- –
- Schlagworte
- Acidosis, Acute Kidney Injury - blood, Acute Kidney Injury - therapy, Alkalosis, Anticoagulants, Anticoagulants - pharmacology, Biomedical Engineering and Bioengineering, Blood Coagulation - drug effects, Calcium, Calcium - metabolism, Cardiac Surgery, Case Report, Catheters, Circuits, Citric acid, Citric Acid - pharmacology, Complications, Continuous Renal Replacement Therapy - adverse effects, Creatinine, Cystatin C, Female, Hemorrhage, Humans, Iliac Vein, Insertion, Intoxication, Liver Transplantation, Medical instruments, Medicine, Medicine & Public Health, Metabolic acidosis, Metabolism, Middle Aged, Nephrology, Regional development, Thromboembolism, Thrombosis, Tomography, X-Ray Computed, Ultrasonography, Doppler, Color, Venous Thrombosis - diagnosis, Venous Thrombosis - drug therapy, Venous Thrombosis - etiology