Regional citrate anticoagulation and influence of recirculation on ionized calcium levels in the circuit.
J Artif Organs
; 22(4): 341-344, 2019 Dec.
Article
en En
| MEDLINE
| ID: mdl-31444670
ABSTRACT
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 [calciumtotal/Ca2+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.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Coagulación Sanguínea
/
Calcio
/
Ácido Cítrico
/
Trombosis de la Vena
/
Lesión Renal Aguda
/
Terapia de Reemplazo Renal Continuo
/
Vena Ilíaca
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
Límite:
Female
/
Humans
/
Middle aged
Idioma:
En
Revista:
J Artif Organs
Asunto de la revista:
ENGENHARIA BIOMEDICA
Año:
2019
Tipo del documento:
Article
País de afiliación:
Bélgica