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Regional citrate anticoagulation in criticalpatients with liver dysfunction |
WANG Wei, CHANG Ping, LIU Zhan - guo, PENG Sheng, LI Xia - xi, ZHAO Ming, CEN Zhong - ran |
Intensive Care Unit, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China |
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Abstract Objective To explore the safety of regional citrate anticoagulation forcontinuous veno - venous hemofiltration (CVVH) in critical patients with liver dysfunction. Methods 7 patients underwent continuous renal replacement therapy ( CRRT ) using citrate as anticoagulation were retrospectively included in this study. The patients were divided into group A ( normal liver function), group B (liver dysfunction MELD≤25. 13) and group C (liver dysfunction MELD > 25. 13). Respective values of blood gas (pH, base excess), lactic acid, ionized calcium and total calcium in 2 hours prior to CRRT and 6 hours after CRRT were observed and analyzed. Results A total of 77 patients (103 cases of CRRTs) were included in the study. Comparing to 2 hours prior to CRRT, the ionized calcium, total calcium and base excess in 6 hours after CRRT were significantly higher in all groups(P < 0. 05), pH and lactic acid in 6 hours after CRRT were similar in all groups( P > 0. 05). Ionized calcium, total calcium, base excess were not significantly different in 3 groups in 6 hours after CRRT( P > 0. 05). Conclusions Regional citrateanticoagulation in CVVH does not cause acid - base balance and electrolyte disorder. Thus it is safe to operate in liver dysfunction patients.
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Received: 12 September 2015
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Corresponding Authors:
CEN Zhong - ran, E - mail: cenzhr2014@ 163. com
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