Citrate anticoagulation in the ICU: the Leeds experience.
Continuous renal replacement therapy (CRRT) is widely used in the management of critically ill patients with acute kidney injury. It requires effective anticoagulation of the extracorporeal blood circuit. Although heparin is the most commonly prescribed anticoagulant, there are issues associated with heparin, and there has been increasing interest in regional citrate anticoagulation as an alternative. In 2013, The Leeds Teaching Hospitals NHS Trust switched from heparin to citrate anticoagulant for CRRT in intensive care units (ICUs) across the Trust. This article examines the reasons for the switch, the implementation of citrate and the impact of this quality-improvement project in terms of patient outcome data and feedback from the ICU nursing team.
Renal ICU Nurse Specialist, The Leeds Teaching Hospitals NHS Trusts.
Charlotte
C
Trumper
D058186:Acute Kidney Injury / Q000451:nursing / Q000628:therapy*; D000925:Anticoagulants / Q000627:therapeutic use*; D019343:Citric Acid / Q000627:therapeutic use*; D016638:Critical Illness / Q000451:nursing / Q000628:therapy*; D004739:England; D006470:Hemorrhage / Q000139:chemically induced; D006493:Heparin / Q000009:adverse effects; D006801:Humans; D007362:Intensive Care Units; D010865:Pilot Projects; D058996:Quality Improvement; D006435:Renal Dialysis / Q000379:methods* / Q000451:nursing; D013222:State Medicine; D013921:Thrombocytopenia / Q000139:chemically induced
D000925:Anticoagulants; D019343:Citric Acid; D006493:Heparin
Acute kidney injury; Audit; Critical care; Dialysis; Liver impairment; Service improvement