Your browser doesn't support javascript.
loading
Automated regional citrate anticoagulation system based on individualized dosing models in nonliver failure patients undergoing PIRRT therapy.
Zhang, Qi; Ding, Damin; Wang, Chaobin; Lu, Jianxin; Zhu, Qin; Ding, Feng.
Affiliation
  • Zhang Q; Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
  • Ding D; Shanghai Superb Medical Technology Co., Ltd, Shanghai, China.
  • Wang C; Shanghai Superb Medical Technology Co., Ltd, Shanghai, China.
  • Lu J; Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
  • Zhu Q; Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
  • Ding F; Division of Nephrology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Ren Fail ; 46(2): 2387207, 2024 Dec.
Article in En | MEDLINE | ID: mdl-39238242
ABSTRACT

INTRODUCTION:

Regional citrate anticoagulation is a preferred option for renal replacement therapy in critically ill patients. However, current implementations ignore individual differences that may exist in the fluctuation of patients' ionized calcium levels. To address this problem, individualized citrate and calcium supplementation models were established based on the pharmacokinetic and clearance characteristics of citrate, and an automated regional citrate anticoagulation system was built with these models as its core to facilitate the treatment of clinical patients. This study was designed to preliminarily evaluate the safety and efficacy of this system, the SuperbMed® RCA-SP100 automated regional citrate anticoagulation system, in prolonged intermittent renal replacement therapy.

METHODS:

Seven patients undergoing prolonged intermittent renal replacement therapy completed treatment with the SuperbMed® RCA-SP100 system. In vivo and in vitro ionized calcium levels were measured every hour before and after the start of dialysis. The accuracy and alarm sensitivity of the pumps were also monitored.

RESULTS:

During seven treatments, the average extracorporeal ionized calcium level was 0.34 ± 0.02 mmol/L, and the mean ionized calcium level in vivo was 1.09 ± 0.07 mmol/L. No patient required intervention, and there was no filter coagulation. The pumps all had an absolute accuracy less than 5%, and alarms could be triggered precisely.

CONCLUSIONS:

We reported on an automated system that allows for individualized citrate and calcium supplementation in prolonged intermittent renal replacement therapy and enables the precise and secure implementation of regional citrate anticoagulation.
Subject(s)
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Renal Replacement Therapy / Citric Acid / Anticoagulants Limits: Aged / Female / Humans / Male / Middle aged Language: En Journal: Ren Fail Journal subject: NEFROLOGIA Year: 2024 Document type: Article Affiliation country: China Country of publication: Reino Unido

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Renal Replacement Therapy / Citric Acid / Anticoagulants Limits: Aged / Female / Humans / Male / Middle aged Language: En Journal: Ren Fail Journal subject: NEFROLOGIA Year: 2024 Document type: Article Affiliation country: China Country of publication: Reino Unido