title: Outcomes of Continuous Renal Replacement Therapy With Regional Citrate Anticoagulation in Small Children After Cardiac Surgery: Experience and Protocol From a Single Center.
abstract: Patients after a cardiac surgery in cardiopulmonary bypass often present an acute kidney failure. Continuous renal replacement therapy (CRRT) is often required. The aim of this study was to present effectiveness and safety of CRRT with regional citrate anticoagulation (RCA-CRRT) in small children after cardiac surgery. A retrospective analysis was conducted on 15 patients after cardiac surgery and who had RCA-CRRT performed in 2014. The established protocol was followed. Mean time on the RCA-CRRT was 192 h 40 min with the circuit mean lifetime of 43 h 33 min. Clotting was found to be a cause of shutdown in 29% of circuits. No severe electrolyte and metabolic disorders were observed. The RCA-CRRT is a safe procedure for critically ill children with contraindications to the CRRT with heparin anticoagulation. To avoid adverse effects related to metabolic disorders a proper procedure protocol has to be followed.
authors: Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, Poznan, Poland.
authors: Anna
authors: A
authors: Musielak
authors: Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, Poznan, Poland.
authors: Alfred
authors: A
authors: Warzywoda
authors: Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, Poznan, Poland.
authors: Michał
authors: M
authors: Wojtalik
authors: Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, Poznan, Poland.
authors: Bartłomiej
authors: B
authors: Kociński
authors: Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, Poznan, Poland.
authors: Paweł
authors: P
authors: Kroll
authors: Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, Poznan, Poland.
authors: Danuta
authors: D
authors: Ostalska-Nowicka
authors: Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, Poznan, Poland.
authors: Jacek
authors: J
authors: Zachwieja
mesh_terms: D058186:Acute Kidney Injury / Q000628:therapy*; D000925:Anticoagulants / Q000627:therapeutic use*; D006348:Cardiac Surgical Procedures; D002675:Child, Preschool; D002951:Citrates / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications / Q000628:therapy*; D017582:Renal Replacement Therapy / Q000379:methods*; D012189:Retrospective Studies; D013995:Time; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D002951:Citrates
keywords: Anticoagulation; Children; Citrate; Hemodiafiltration; Renal replacement therapy