Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/10009
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dc.contributor.authorNaka, Toshioen
dc.contributor.authorEgi, Moritokien
dc.contributor.authorBellomo, Rinaldoen
dc.contributor.authorCole, Louiseen
dc.contributor.authorFrench, Cen
dc.contributor.authorBotha, Jen
dc.contributor.authorWan, Lien
dc.contributor.authorFealy, Nigel Gen
dc.contributor.authorBaldwin, Ian Cen
dc.date.accessioned2015-05-15T23:19:14Z
dc.date.available2015-05-15T23:19:14Z
dc.date.issued2005-10-01en
dc.identifier.citationAnaesthesia and Intensive Care; 33(5): 601-8en
dc.identifier.govdoc16235478en
dc.identifier.otherPUBMEDen
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/10009en
dc.description.abstractThis study assessed the safety and efficacy of a commercial low-citrate concentration-based pre-filter replacement fluid during continuous veno-venous haemofiltration (CVVH) in patients with frequent filter clotting and high risk of bleeding. We used a commercial low-citrate fluid as pre-dilution replacement fluid during CVVH (citrate: 11 mmol/l (33 meq/l), sodium: 140 mmol/l, chloride: 108 mmol/l and potassium: 1 mmol/l). A calcium and magnesium infusion was delivered separately by central line for the maintenance of serum ionized calcium (Cai) and total magnesium (Mg). In this prospective observational study, 30 patients, 124 filters and 1,515 treatment-hours were observed. Median filter life of citrate CVVH was 9.5 hours. Filter life in the 48 hours prior to citrate CVVH was also observed. In the patients on prior non-anticoagulant CVVH (n=14) filter life increased significantly with citrate (9.5 hours vs 5 hours; P<0.0001). In patients on prior heparin CVVH (n = 15), filter life was similar with citrate (10 hours vs 8 hours; P = 0.68). However, in patients with prior early/frequent filter clotting despite heparin (n = 11) filter life increased significantly (10 hours vs 7 hours; P=0.038). Of 411 serum Cai measurements, none showed a Cai < 0.85 mmol/l and, of 84 observations, none showed a serum Mg<0. 6 mmol/l. One patient with sepsis and shock needed to cease citrate CVVH because of progressive ionized hypocalcaemia and increasing anion gap. No other adverse effects were observed. In selected patients, CVVH with a commercial low-citrate concentration solution as pre-filter replacement fluid and a simultaneous calcium and magnesium infusion protocol appears generally safe. Filter life was acceptable and superior to that achieved with previous treatment.en
dc.language.isoenen
dc.subject.otherAcute Kidney Injury.therapyen
dc.subject.otherAgeden
dc.subject.otherAnticoagulants.therapeutic useen
dc.subject.otherCalcium.blooden
dc.subject.otherCitrates.therapeutic useen
dc.subject.otherFemaleen
dc.subject.otherHemofiltration.methodsen
dc.subject.otherHospital Mortalityen
dc.subject.otherHumansen
dc.subject.otherIntensive Care Unitsen
dc.subject.otherMagnesium.blooden
dc.subject.otherMaleen
dc.subject.otherProspective Studiesen
dc.subject.otherRisk Factorsen
dc.titleCommercial low-citrate anticoagulation haemofiltration in high risk patients with frequent filter clotting.en
dc.typeJournal Articleen
dc.identifier.journaltitleAnaesthesia and Intensive Careen
dc.identifier.affiliationDepartment of Intensive Care and Medicine (University of Melbourne), Austin Hospital, Austin Health, Victoria.en
dc.description.pages601-8en
dc.relation.urlhttps://pubmed.ncbi.nlm.nih.gov/16235478en
dc.type.austinJournal Articleen
local.name.researcherBaldwin, Ian C
item.openairetypeJournal Article-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.grantfulltextnone-
item.fulltextNo Fulltext-
item.cerifentitytypePublications-
item.languageiso639-1en-
crisitem.author.deptIntensive Care-
crisitem.author.deptData Analytics Research and Evaluation (DARE) Centre-
crisitem.author.deptIntensive Care-
crisitem.author.deptIntensive Care-
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