Citrate Anticoagulation for Continuous Renal Replacement Therapy in Small Children

Overview

Journal Pediatr Nephrol

Specialties Nephrology
Pediatrics

Date 2013 Dec 17

PMID 24337319

Citations 20

Authors

Jolanta Soltysiak

Alfred Warzywoda

Bartlomiej Kocinski

Danuta Ostalska-Nowicka

Anna Benedyk

Magdalena Silska-Dittmar

Jacek Zachwieja

Affiliations

Soon will be listed here.

Abstract

Background: Regional citrate anticoagulation (RCA) is one of the methods used to prevent clotting in continuous renal replacement therapy (CRRT). The aim of this study was to describe the outcomes and complications of RCA-CRRT in comparison to heparin anticoagulation (HA)-CRRT in critically ill children.

Methods: This study was a retrospective review of 30 critically ill children (16 on RCA- and 14 on HA-CRRT) who underwent at least 24 h of CRRT. The mean body weight of the children was 8.69 ± 5.63 kg. RCA-CRRT was performed with a commercially available pre-dilution citrate solution (Prismocitrate 18/0).

Results: The mean time on RCA-CRRT and HA-CRRT was 148.73 ± 131.58 and 110.24 ± 105.38 h, respectively. Circuit lifetime was significantly higher in RCA-CRRT than in HA-CRRT (58.04 ± 51.18 h vs. 37.64 ± 32.51 h, respectively; p = 0.030). Circuit clotting was observed in 11.63 % of children receiving RCA-CRRT and 34.15 % of those receiving HA-CRRT. Episodic electrolyte and metabolic disturbances were more common in children receiving RCA-CRRT. The survival at discharge from the hospital was 37.5 and 14.3 % among children receiving RCA-CRRT and HA-CRRT, respectively.

Conclusions: In critically ill children with a low body weight, RCA appeared to be safe and easy to used. Among our patient cohort, RCA was more effective in preventing circuit clotting and provided a better circuit lifetime than HA.

Citing Articles

A Comparison of the Anticoagulation Efficacy and Safety of Epoprostenol to Heparin and Citrate in Children Receiving Continuous Renal Replacement Therapy.

Sondhi E, Stewart M, Harper J, Konyk L, McSteen C, Crowley K Blood Purif. 2024; 53(10):838-846.

PMID: 38991509 PMC: 11444869. DOI: 10.1159/000540302.

Citrate anticoagulation and systemic heparin anticoagulation during continuous renal replacement therapy among critically-ill children.

Atis S, Duyu M, Karakaya Z, Yilmaz A Pediatr Res. 2024; 96(3):702-712.

PMID: 38555381 PMC: 11499251. DOI: 10.1038/s41390-024-03163-x.

Continuous renal replacement therapy in neonates and children: what does the pediatrician need to know? An overview from the Critical Care Nephrology Section of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC).

Cortina G, Daverio M, Demirkol D, Chanchlani R, Deep A Eur J Pediatr. 2023; 183(2):529-541.

PMID: 37975941 PMC: 10912166. DOI: 10.1007/s00431-023-05318-0.

Clinical application of regional citrate anticoagulation for membrane-based therapeutic plasma exchange in children with liver failure.

Hu J, Wang C, Bai K, Liu C Front Pediatr. 2023; 11:1206999.

PMID: 37928357 PMC: 10621744. DOI: 10.3389/fped.2023.1206999.

Evaluation of the efficacy and associated complications of regional citrate anticoagulation in neonates: experience from a fourth level neonatal intensive care unit.

Kostekci Y, Kendirli T, Gun E, Ucmak H, Demirtas F, Havan M Eur J Pediatr. 2023; 182(11):4897-4908.

PMID: 37597047 DOI: 10.1007/s00431-023-05162-2.

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