Regional Citrate Anticoagulation and Systemic Anticoagulation during Pediatric Continuous Renal Replacement Therapy: A Systematic Literature Review.
J Clin Med
; 11(11)2022 May 31.
Article
em En
| MEDLINE
| ID: mdl-35683511
ABSTRACT
BACKGROUND:
Clotting is a major drawback of continuous renal replacement therapy (CRRT) performed on critically ill pediatric patients. Although anticoagulation is recommended to prevent clotting, limited results are available on the effect of each pharmacological strategy in reducing filter clotting in pediatric CRRT. This study defines which anticoagulation strategy, between regional citrate anticoagulation (RCA) and systemic anticoagulation with heparin, is safer and more efficient in reducing clotting, patient mortality, and treatment complications during pediatric CRRT.METHODS:
A systematic literature review was run considering papers published in English until December 2021 and describing patients' and treatments' complications in CRRT performed with heparin and RCA on patients aged less than 18 years.RESULTS:
Eleven studies were considered, cumulatively comprising 1.706 CRRT sessions (62% with systemic anticoagulation and 38% with RCA). Studies have consistently identified RCA's superiority over systemic anticoagulation with heparin in prolonging circuit life. The pooled estimate (95% CI) of filter clotting risk showed that RCA is a protective factor for clotting risk (RR = 0.204).CONCLUSIONS:
RCA has a potential role in prolonging circuit life and seems superior to systemic anticoagulation with heparin in decreasing the risk of circuit clotting during CRRT performed in critically ill pediatric patients.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
6_ODS3_enfermedades_notrasmisibles
Problema de saúde:
6_kidney_renal_pelvis_ureter_cancer
Tipo de estudo:
Prognostic_studies
/
Systematic_reviews
Idioma:
En
Revista:
J Clin Med
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Itália