Chinese Journal of Nephrology, Dialysis & Transplantation

ISSN 1006-298X      CN 32-1425/R

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Chinese Journal of Nephrology, Dialysis & Transplantation ›› 2021, Vol. 30 ›› Issue (2): 119-123.DOI: 10.3969/j.issn.1006298X.2021.02.004

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Postfilter ionic calcium concentration during continuous venous-venous hemofiltration under regional citrate anticoagulation in critical patients

  

  1. Ｏｂｊｅｃｔｉｖｅ：To study parameters setting and the relationship between postfilter ionized calcium concentrations(［iCa2+］postfilter)and lifespans of filters during continuous venousvenous hemofiltration under regional citrate anticoagulation (RCACVVH).
    Ｍｅｔｈｏｄｏｌｏｇｙ：Patients treated with RCACVVH from June 1st 2016 to July 31st2017,were enrolled in the study.Blood flow velocity and sodium citrate velocity were set unchanged (blood flow: 180ml／min,4％ sodium citrate: 220 ml／h).The internal environment and lifespans of filters were observed during hemofiltration.According to different values of ［iCa2+］postfilter,the data was divided into three groups: Group C1(［iCa2+］postfilter≤045 mmol／L),Group C2(045<［iCa2+］postfilter≤055 mmol／L),Group C3(［iCa2+］postfilter>055mmol／L).The lifespans of filters and surviving rates in 48th hour were compared.According to different lifespans of filters,the data was divided into three groups: Group T1(t≤24h),Group T2(24h<t≤48h),Group T3(t>48h).［Ca2+］ postfilter of three groups were compared.The relation of ［iCa2+］ postfilter and lifespans of filters were analyzed.
    Ｒｅｓｕｌｔｓ：Totally 56 patients and 114 times of CVVH in the same setting were enrolled.(1)The mean lifespan was 4627±1882h,and the mean ［iCa2+］postfilter was 052±008mmol／L,the mean systemic iron calcium was 101±019mmol／L.(2) There were no bleeding,metabolism disarrangements during RCACVVH.(3) The lifespans of Group C1,C2 and C3were 4193±1726h,4775±1991h and 4645±1799h individually,and there was no statistical difference among the three groups(F=073,P>005).The 48h“surviving rates “were 3333％,4386％,4722％.Differences were not significant(χ2=108,P>005).(4) ［iCa2+］postfilterin group T1,T2 and T3 were 049±007、051±008、053±007mmol／L(F=186,P>005).There was no statistical difference among the three groups.(5) The rvalue for the correlation between ［iCa2+］ postfilter and lifespans of filters was 013(P>005).
    Ｃｏｎｃｌｕｓｉｏｎ：To maintain a fixed ratio of sodium citrate and blood flow during RCACVVH,target of ［iCa2+］ postfilter could be extended,thus not only treatment is safe and efficient,the difficulty of adjusting the treatment parameters could be avoided partly,but also lifespans of filters are not influenced,and risk of metabolic disorders is reduced.

  • Online:2021-04-28 Published:2021-06-06

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Abstract: citrate，continuous veno-venous hemofiltration，regional citrate anticoagulation

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