Regional sodium citrate anticoagulation in patients with active bleeding undergoing hemodialysis.
Sodium citrate was used as a regional anticoagulant in the dialysis system in four patients with acute renal failure and active bleeding of various sources during a total of 38 dialysis treatments. All four patients had exacerbation of existing hemorrhage with low-dose heparin dialysis. A special circuit was used through which sodium citrate was infused into the arterial sleeve of the dialysis blood line; dialysis was achieved against calcium-free bath and calcium was infused into the venous sleeve of the dialysis blood line. When data was compared to low-dose heparin dialysis, citrate anticoagulation is as effective, carries no risk of exacerbation of bleeding, and had negligible adverse effects.
D000368:Aged; D001639:Bicarbonates / Q000097:blood; D002118:Calcium / Q000097:blood; D002951:Citrates / Q000008:administration & dosage / Q000627:therapeutic use*; D019343:Citric Acid; D003404:Creatinine / Q000097:blood; D005260:Female; D006470:Hemorrhage / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D010976:Platelet Count; D006435:Renal Dialysis; D014914:Whole Blood Coagulation Time
D001639:Bicarbonates; D002951:Citrates; D019343:Citric Acid; D003404:Creatinine; D002118:Calcium