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dc.contributor.authorEgi, Moritokien
dc.contributor.authorNaka, Toshioen
dc.contributor.authorBellomo, Rinaldoen
dc.contributor.authorCole, Louiseen
dc.contributor.authorFrench, Cen
dc.contributor.authorTrethewy, Cen
dc.contributor.authorWan, Lien
dc.contributor.authorLangenberg, Christophen
dc.contributor.authorFealy, Nigelen
dc.contributor.authorBaldwin, Ianen
dc.identifier.citationThe International Journal of Artificial Organs; 28(12): 1211-8en
dc.description.abstractTo assess the safety and efficacy of two different commercial citrate containing pre-filter replacement fluids during continuous veno-venous hemofiltration (CVVH) in patients with frequent filter clotting.Four intensive care units.Sixty-three critically ill patients with acute renal failure (ARF).Prospective observational study.We used a commercial citrate fluid (citrate: 11 mmol/L -fluid A) as predilution replacement for CVVH. We then changed to a new commercial citrate fluid (citrate: 14 mmol/L-fluid B) as replacement fluid and performed statistical comparisons. Replacement fluid rate was fixed at 2,000 ml/hour.Filter life was 12.2 hour with fluid A compared with 17.1 hour with fluid B on average (p=0.0001). Mean post filter ionized calcium concentration was 0.52 mmol/L with fluid A compared with 0.40 mmol/L with fluid B (p<0.0001). Citrate intolerance led to cessation of treatment in one patient with fluid A and one patient with fluid B. Overall ionized calcium levels were higher (A: 1.18 vs B: 1.13 mmol/L; p<0.0001) and bicarbonate was lower (A: 22.4 vs B: 24.5 mmol/L; p<0.0001) during treatment with fluid A. Alkalemia was seen in 10 patients treated with fluid A and 16 patients treated with fluid B (NS).We have developed a simple approach to regional citrate anticoagulation for CVVH using a commercial citrate-containing fluid as replacement fluid. Increasing citrate concentration from 11 to 14 mmol/L increased filter life while maintaining relative safety and simplicity.en
dc.subject.otherAcute Kidney Injury.therapyen
dc.subject.otherAnticoagulants.therapeutic useen
dc.subject.otherChi-Square Distributionen
dc.subject.otherCitrates.therapeutic useen
dc.subject.otherCritical Illnessen
dc.subject.otherDialysis Solutions.therapeutic useen
dc.subject.otherMiddle Ageden
dc.subject.otherProspective Studiesen
dc.subject.otherStatistics, Nonparametricen
dc.titleA comparison of two citrate anticoagulation regimens for continuous veno-venous hemofiltration.en
dc.typeJournal Articleen
dc.identifier.journaltitleInternational Journal of Artificial Organsen
dc.identifier.affiliationDepartment of Intensive Care and Department of Medicine, Austin Hospital and Melbourne University, Melbourne - Australiaen
Appears in Collections:Journal articles

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