A target-oriented algorithm for citrate-calcium anticoagulation in clinical practice.
OBJECTIVE
Because of a high monitoring demand and an ensuing need for automation of regional citrate anticoagulation (RCA), a new semi-automated target-oriented algorithm was developed. The aim of this study was the evaluation of its functionality and safety.


METHODS
Fourteen haemodialysis patients were treated 5 times consecutively with RCA. Samples were drawn pre- and post-infusion once per hour. Electrolytes, blood cell counts, acid-base and coagulation parameters were analyzed.


RESULTS
Mean ionized calcium (Ca(2+)) values pre-filter were 0.23 and 0.33 mmol/l in the 0.2 and 0.3 mmol/l target groups, respectively. Extraction ratios for citrate and total calcium through the dialysis filter were constant during the entire treatment (83 and 68%, respectively). Citrate accumulation was avoided.


CONCLUSIONS
The new algorithm enables safe and accurate RCA. By regulating Ca(2+) pre-filter using the target-oriented algorithm, the degree of anticoagulation may be easily controlled.
Center for Biomedical Technology, Danube University Krems, Krems, Austria.
Karin
K
Strobl
Jens
J
Hartmann
Manfred
M
Wallner
Martin
M
Brandl
Dieter
D
Falkenhagen
D000328:Adult; D000465:Algorithms; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D001777:Blood Coagulation / Q000187:drug effects*; D002118:Calcium / Q000097:blood; D019355:Calcium Citrate / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome
D000925:Anticoagulants; D019355:Calcium Citrate; D002118:Calcium