Faculty Opinions recommendation of Evaluating the safety and efficacy of regional citrate compared to systemic heparin as anticoagulation for continuous renal replacement therapy in critically ill patients: A service evaluation following a change in practice.

2017 ◽  
Author(s):  
Ashita Tolwani ◽  
Keith Wille
Keyword(s):  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Service Evaluation ◽  
Safety And Efficacy ◽  
Change In Practice

scholarly journals Evaluating the safety and efficacy of regional citrate compared to systemic heparin as anticoagulation for continuous renal replacement therapy in critically ill patients: A service evaluation following a change in practice

2017 ◽  
Vol 18 (3) ◽  
pp. 184-192 ◽  
Author(s):  
Roberta Borg ◽  
Debra Ugboma ◽  
Dawn-Marie Walker ◽  
Richard Partridge
Keyword(s):  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Service Evaluation ◽  
First Year ◽  
First Line ◽  
Safety And Efficacy ◽  
Significant Difference ◽  
Change In Practice ◽  
Median Lifespan

Following the implementation of citrate anticoagulation for continuous renal replacement therapy, we evaluate its first year of use and compare it to the previously used heparin, to assess whether our patients benefit from the recently reported advantages of citrate. We retrospectively analysed 2 years of data to compare the safety and efficacy of citrate versus heparin. The results have shown that 43 patients received continuous renal replacement therapy with heparin, 37 patients with citrate. We found no significant difference in metabolic control of pH, urea and creatinine after 72 h. Filters anticoagulated with citrate had significantly longer median lifespan (33 h vs 17 h; p = 0.001), shorter downtime (0 h vs 5 h; p = 0.015) and less filter sets per patient day (0.37 vs 0.67; p = 0.002). Filters anticoagulated with heparin were commonly interrupted due to clotting (50% vs 16.4%), whereas filters anticoagulated with citrate were often stopped electively (53.4% vs 24.6%). Patients on heparin filters had significantly higher APPTs, some at potentially dangerous levels (>180 s), whilst patients on citrate filters had significantly higher levels of bicarbonate. Therefore, we conclude that citrate is superior in terms of safety and efficacy, with longer filter lifespan. It has become our first line anticoagulant for continuous renal replacement therapy.

scholarly journals Vancomycin therapy in critically ill patients on continuous renal replacement therapy; are we doing enough?

2015 ◽  
Vol 23 (3) ◽  
pp. 327-329 ◽  
Author(s):  
Ali S. Omrani ◽  
Alaa Mously ◽  
Marylie P. Cabaluna ◽  
John Kawas ◽  
Mohammed M. Albarrak ◽  
...  
Keyword(s):  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Vancomycin Therapy
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