title: A target-orientated algorithm for regional citrate-calcium anticoagulation in extracorporeal therapies.
abstract: BACKGROUND
  Citrate anticoagulation offers several advantages in comparison to conventional anticoagulation. Most algorithms for regional citrate-calcium anticoagulation are based on citrate and calcium chloride infusion coupled in a fixed proportion to the blood flow without considering the hematocrit (Hct)/plasma flow or the filter clearance of citrate and calcium.
  
  
  METHODS
  The aim of this study was to develop an algorithm for optimized citrate anticoagulation in extracorporeal therapies such as dialysis. A mathematical model was developed to calculate the volume of citrate infusion required to achieve a desired ionized calcium (iCa) target level in the extracorporeal circuit and to restore the total calcium level to a physiological value.
  
  
  RESULTS
  The model was validated by correlation analyses for different blood Hct values and shows an excellent fit to the laboratory measurements.
  
  
  CONCLUSIONS
  The results for both iCa target concentrations, namely those after citrate and calcium infusion, proved that the software algorithm adapts well to variable treatment parameters.
authors.affiliation: Center for Biomedical Technology, Danube University Krems, Krems, Austria. martin.brandl @ donau-uni.ac.at
authors.forename: M
authors.initials: M
authors.lastname: Brandl
authors.forename: K
authors.initials: K
authors.lastname: Strobl
authors.forename: J
authors.initials: J
authors.lastname: Hartmann
authors.forename: K
authors.initials: K
authors.lastname: Kellner
authors.forename: T
authors.initials: T
authors.lastname: Posnicek
authors.forename: D
authors.initials: D
authors.lastname: Falkenhagen
mesh_terms: D000465:Algorithms; D000925:Anticoagulants / Q000494:pharmacology / Q000627:therapeutic use*; D001798:Blood Proteins / Q000378:metabolism; D002118:Calcium / Q000494:pharmacology / Q000627:therapeutic use*; D002122:Calcium Chloride / Q000494:pharmacology / Q000627:therapeutic use; D019343:Citric Acid / Q000494:pharmacology / Q000627:therapeutic use*; D004867:Equipment Design; D006801:Humans; D008954:Models, Biological; D006435:Renal Dialysis / Q000295:instrumentation* / Q000379:methods
chemical_list: D000925:Anticoagulants; D001798:Blood Proteins; D019343:Citric Acid; D002122:Calcium Chloride; D002118:Calcium