title: [Role of local citrate anticoagulation in continuous blood purification to patients at high risk of bleeding in ICU].
abstract: To evaluate the safety and efficiency of citrate anticoagulant-based continuous blood purification in patients at high risk of bleeding.   Methods: One hundred and fifty-two patients at high risk of bleeding were divided into local citrate group (group A, n=68) and heparin group (group B, n=84). Clotting function, change of pH, ionized sodium, bicarbonate ion, ionized calcium, activated clotting time (ACT) and complications were monitored before and during treatment.   Results: Compared to the group A, the incidence of clotting in filter and chamber, the degree of bleeding or fresh bleeding were significantly reduced in the group B (P<0.05). ACT of post-filter at 4, 8 and 12 h during the treatment in the group A was significantly extended compared with that without treatment (P<0.05), while there was no significant change in group B (P>0.05). The pH value, the levels of ionized sodium, bicarbonate ion and ionized calcium during the treatment were maintained in normal range in both group A and group B.  Conclusion: Local citrate-based continuous blood purification can achieve effective anticoagulation and decrease the incidence of bleeding. It is an ideal choice for patients at high risk of bleeding.
authors.affiliation: (Center of Critical Care Medicine, Third Xiangya Hospital, Central South University, Changsha 410013, China.
authors.forename: Shangping
authors.initials: S
authors.lastname: Zhao
authors.affiliation: (Center of Critical Care Medicine, Third Xiangya Hospital, Central South University, Changsha 410013, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Ou
authors.affiliation: (Center of Critical Care Medicine, Third Xiangya Hospital, Central South University, Changsha 410013, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Peng
authors.affiliation: (Center of Critical Care Medicine, Third Xiangya Hospital, Central South University, Changsha 410013, China.
authors.forename: Zuoliang
authors.initials: Z
authors.lastname: Liu
authors.affiliation: (Center of Critical Care Medicine, Third Xiangya Hospital, Central South University, Changsha 410013, China.
authors.forename: Mingshi
authors.initials: M
authors.lastname: Yang
authors.affiliation: (Center of Critical Care Medicine, Third Xiangya Hospital, Central South University, Changsha 410013, China.
authors.forename: Xuefei
authors.initials: X
authors.lastname: Xiao
mesh_terms: D000925:Anticoagulants / Q000494:pharmacology; D001639:Bicarbonates / Q000097:blood; D001777:Blood Coagulation / Q000187:drug effects*; D001780:Blood Coagulation Tests; D002118:Calcium / Q000097:blood; D002951:Citrates; D019343:Citric Acid / Q000627:therapeutic use*; D005260:Female; D017583:Hemodiafiltration / Q000009:adverse effects* / Q000379:methods; D006440:Hemofiltration; D006470:Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D012016:Reference Values; D006435:Renal Dialysis; D012964:Sodium / Q000097:blood; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D001639:Bicarbonates; D002951:Citrates; D019343:Citric Acid; D006493:Heparin; D012964:Sodium; D002118:Calcium