Feasibility and efficacy of modified fixed citrate concentration protocol using only commercial preparations in critically ill patients: a prospective cohort study with a historical control group

Background The cumbersome program and the shortage of commercial solution hindered the regular application of regional citrate anticoagulation (RCA). It is urgent to simplify the protocol using only commercial preparations. The aim of this study was to explore the feasibility and efficacy of the modified protocol for continuous veno-venous hemofiltration (CVVH) in unselected critically ill patients. Methods A prospective cohort study was conducted in 66 patients who received a new protocol combining fixed citrate concentration with modified algorithm for supplements (i.e., fixed protocol), and compared the efficacy, safety and convenience for this group to a historical control group with a traditional protocol (n = 64), where citrate was titrated according to the circuit ionized calcium concentration (i.e., titrated protocol). The convenience was defined as the demand for monitoring test and dose adjustment of any supplement. Results The filter lifespan was 63.2 ± 16.1 h in the fixed group and 51.9 ± 17.7 h in the titrated group, respectively. Kaplan-Meier survival analysis demonstrated longer circuit lifetime for fixed group (log-rank, p = 0.026). The incidence of circuit clotting was lower in the fixed protocol (15.2% vs. 29.7% in the titrated protocol, p = 0.047). Moreover, compared with the titrated group, patients with fixed protocol had less demand for monitoring test and dose adjustment of any supplement (the number of times per person per day) (3.3 [IQR 2.3–4.5] vs. 5.7 [IQR 3.3–6.9], p = 0.001 and 1.9 [IQR 0.5–2.7] vs. 6.3 [IQR 4.2–7.9], p < 0.001; respectively). No new onset bleeding complications occurred in all patients. The overall incidence of suspected citrate accumulation was 4.6% and there was no difference between the two groups (p = 0.969), yet a lower rate of metabolic alkalosis was found in the fixed group (3.0% vs. 14.1%, p = 0.024). Conclusions Our modified fixed citrate concentration protocol is feasible, safe and effective to enhance the circuit lifespan and the convenience of implementation while maintaining a similar safety when compared to the traditional protocol. Using only commercial preparations may be helpful for widespread application of RCA. Trial registration Clinicaltrials.gov. NCT02663960. Registered 26 January 2016.

Measurement of the Concentration of Citrate in Human Biofluids in Patients Undergoing Continuous Renal Replacement Therapy Using Regional Citrate Anticoagulation: Application of a Two-Step Enzymatic Assay

<b><i>Background:</i></b> Continuous renal replacement therapy (CRRT) with regional citrate anticoagulation (RCA) is now commonly used to treat acute kidney injury in critically ill patients. The concentration of citrate is not routinely measured, with citrate accumulation and/or toxicity primarily assessed using surrogate measures. <b><i>Objectives:</i></b> The aim of this study was to measure the concentration of citrate in plasma and ultrafiltrate in patients receiving CRRT with RCA using a modified commercial enzymatic assay. <b><i>Methods:</i></b> After meeting inclusion criteria, blood was sampled from 20 patients before, during, and after episodes of filtration. Using spectrophotometry, samples were tested for citrate concentration. Demographic and other clinical and biochemical data were also collected. Throughout, a 15 mmol/L solution of trisodium citrate was used as the prefilter anticoagulant. Results were analysed using STATA (v15.0) and presented as mean (SD), median (IQR), or simple proportion. Comparisons were made using either the Student <i>t</i> test or the Wilcoxon rank-sum test. Correlation was assessed using Pearson’s <i>r</i>. <b><i>Results:</i></b> Twenty patients (17 males) were enrolled in the study. Mean (SD) age was 63.7 years (9.9). Median (IQR) ICU length of stay was 281 h (199, 422) with 85% undergoing intermittent positive pressure ventilation. Median APACHE 3 score was 95 (87, 117) with an overall 30% mortality rate. Median filtration time was 85 h (46, 149). No difference was found between pre- and post-filtration plasma citrate concentrations (79 µmol/L [50] vs. 71 µmol/L [42], <i>p</i> = 0.65). Mean citrate concentration during filtration was 508 µmol/L (221) with a maximum of 1,070 µmol/L. This was significantly higher than the pre/post levels (<i>p</i> &#x3c; 0.001). <b><i>Conclusions:</i></b> Plasma concentrations of citrate rose significantly during episodes of CRRT using RCA returning back to normal after cessation of treatment.

Isoquinoline-based Eu(iii) luminescent probes for citrate sensing in complex matrix

Optical response of Eu(bisoQcd)OTf and Eu(isoQC3A) complexes is selective and sensitive towards citrate concentration, in a complex matrix simulating an interstitial extracellular fluid.

Adsorbed leucaena protein on citrate modified Fe3O4 nanoparticles: synthesis, characterization, and its application as magnetic coagulant

Natural coagulants from plants resources have gained a lot of attention as it is renewable, biodegradable, non-hazardous, lower cost, and less sludge generated compared to chemical coagulants. However there are still some drawbacks, namely long settling time and possible increase of dissolved organic carbon in the treated water. In this paper we tried to address these drawbacks by utilizing citrate modified Fe3O4 to adsorb protein from Leucaena leucocephala as the active coagulating agent. The effect of trisodium citrate concentration and protein adsorption pH to the adsorbed protein was investigated. It was found that the trisodium citrate concentration of 0.5 M and pH 4.0 gave the highest protein adsorption. The obtained magnetic coagulant was furthermore characterized using Scanning Electron Microscopy, X-ray Diffraction, Fourier Transform Infrared Spectroscopy, and Transmission Electron Microscopy to observe the characteristics before and after protein adsorption. Furthermore, the effect of pH (2 to 10) and coagulant dosage (60 to 600 mg L-1) to the removal of synthetic Congo red wastewater and sludge volume formation was investigated. It was found that pH 3 was the best pH for coagulation due to charge neutralization mechanism of leucaena protein. Furthermore the highest removal was obtained at dosage 420 mg L-1 with 80% removal. This result was comparable with crude extract of leucaena with half settling time (20 min) and lower increase of permanganate value, indicating lower increase of dissolved organics in the treated water.

Adsorbed leucaena protein on citrate modified Fe3O4 nanoparticles: synthesis, characterization, and its application as magnetic coagulant

Natural coagulants from plants resources have gained a lot of attention as it is renewable, biodegradable, non-hazardous, lower cost, and less sludge generated compared to chemical coagulants. However there are still some drawbacks, namely long settling time and possible increase of dissolved organic carbon in the treated water. In this paper we tried to address these drawbacks by utilizing citrate modified Fe3O4 to adsorb protein from Leucaena leucocephala as the active coagulating agent. The effect of trisodium citrate concentration and protein adsorption pH to the adsorbed protein was investigated. It was found that the trisodium citrate concentration of 0.5 M and pH 4.0 gave the highest protein adsorption. The obtained magnetic coagulant was furthermore characterized using Scanning Electron Microscopy, X-ray Diffraction, Fourier Transform Infrared Spectroscopy, and Transmission Electron Microscopy to observe the characteristics before and after protein adsorption. Furthermore, the effect of pH (2 to 10) and coagulant dosage (60 to 600 mg L− 1) to the removal of synthetic Congo red wastewater and sludge volume formation was investigated. It was found that pH 3 was the best pH for coagulation due to charge neutralization mechanism of leucaena protein. Furthermore the highest removal was obtained at dosage 420 mg L− 1 with 80% removal. This result was comparable with crude extract of leucaena with half settling time (20 min) and lower increase of permanganate value, indicating lower increase of dissolved organics in the treated water.

Adsorbed Leucaena protein on citrate modified Fe3O4 nanoparticles: synthesis, characterization, and its application as magnetic coagulant

Natural coagulants from plants resources have gained a lot of attention as it is renewable, biodegradable, non-hazardous, lower cost, and less sludge generated compared to chemical coagulants. However there are still some drawbacks, namely long settling time and possible increase of dissolved organic carbon in the treated water. In this paper we tried to address these drawbacks by utilizing citrate modified Fe3O4 to adsorb protein from Leucaena leucocephala as the active coagulating agent. The effect of trisodium citrate concentration and protein adsorption pH to the adsorbed protein was investigated. It was found that the trisodium citrate concentration of 0.5 M and pH 4.0 gave the highest protein adsorption. The obtained magnetic coagulant was furthermore characterized using SEM, XRD, FTIR, and TEM, to observe the characteristics before and after protein adsorption. Furthermore the effect of pH (2.0 to 10.0) and coagulant dosage (60 to 600 mg L-1) to the removal of synthetic Congo red wastewater and sludge volume formation was investigated. It was found that pH 3.0 was the best pH for coagulation due to charge neutralization mechanism of leucaena protein. Furthermore the highest removal was obtained at dosage 420 mg L-1 with 80% removal. This result was comparable with crude extract of leucaena with half settling time (20 min) and lower increase of permanganate value, indicating lower increase of dissolved organics in the treated water.

Characteristics of TAA–ZnS Buffer Layer by Addition of Sodium Citrate for CIGS Thin Film Solar Cell

Zinc Sulfide (ZnS) is an environmentally friendly material with a wide bandgap (Eg = 3.7 eV) comparable to that of cadmium sulfide (CdS) (2.4 eV), which is conventionally used as buffer layer in Cu(In,Ga)Se2 (CIGS) thin film solar cells. Conventional ZnS buffer layers are manufactured using thiourea, and, these layers possess a disadvantage in that their deposition rate is lower than that of CdS buffer layers. In this paper, thioacetamide (TAA) was used as a sulfur precursor instead of thiourea to increase the deposition rate. However, the ZnS thin films deposited with TAA exhibited a higher roughness than the ZnS thin films deposited with thiourea. Sodium citrate was therefore added to increase the uniformity and decrease the roughness of the former ZnS thin films. When sodium citrate was used, the thin films demonstrated a high transmittance via the controlled generation of particles. In the case of TAA–ZnS thin films doped with a sodium citrate concentration of 0.04 M, the granules on the surface disappeared and these thin films were denser than the TAA–ZnS thin films deposited with a lower sodium citrate concentration. It is considered that the rate of the ion-by-ion reaction increased due to the addition of sodium citrate, thereby resulting in a uniform thin film. Consequently, TAA–ZnS thin films with thicknesses of approximately 40 nm and high transmittances of 83% were obtained when a sodium citrate concentration of 0.04 M was used.

Adsorbed Leucaena protein on citrate modified Fe3O4 nanoparticles: synthesis, characterization, and its application as magnetic coagulant

Natural coagulants from plants resources have gained a lot of attention as it is renewable, biodegradable, non-hazardous, lower cost, and less sludge generated compared to chemical coagulants. However there are still some drawbacks, namely long settling time and possible increase of dissolved organic carbon in the treated water. In this paper we tried to address these drawbacks by utilizing citrate modified Fe3O4 to adsorb protein from Leucaena leucocephala as the active coagulating agent. The effect of trisodium citrate concentration and protein adsorption pH to the adsorbed protein was investigated. It was found that the trisodium citrate concentration of 0.5 M and pH 4.0 gave the highest protein adsorption. The obtained magnetic coagulant was furthermore characterized using SEM, XRD, FTIR, and TEM, to observe the characteristics before and after protein adsorption. Furthermore the effect of pH (2.0 to 10.0) and coagulant dosage (60 to 600 mg L-1) to the removal of synthetic Congo red wastewater and sludge volume formation was investigated. It was found that pH 3.0 was the best pH for coagulation due to charge neutralization mechanism of leucaena protein. Furthermore the highest removal was obtained at dosage 420 mg L-1 with 80% removal. This result was comparable with crude extract of leucaena with half settling time (20 min) and lower increase of permanganate value, indicating lower increase of dissolved organics in the treated water.

Adsorbed Leucaena Protein on Citrate Modified Fe3O4 Nanoparticles: Synthesis, Characterization, and Its Application As Magnetic Coagulant

Natural coagulants from plants resources have gained a lot of attention as it is renewable, biodegradable, non-hazardous, lower cost, and less sludge generated compared to chemical coagulants. However there are still some drawbacks, namely long settling time and possible increase of dissolved organic carbon (DOC) in the treated water. In this paper we tried to address these drawbacks by utilizing citrate modified Fe3O4 to adsorb protein from Leucaena leucocephala as the active coagulating agent. The effect of trisodium citrate concentration and protein adsorption pH to the adsorbed protein was investigated. It was found that the trisodium citrate concentration of 0.5 M and pH 4.0 gave the highest protein adsorption. The obtained magnetic coagulant was furthermore characterized using SEM, XRD, FTIR, and TEM, to observe the characteristics before and after protein adsorption. Furthermore the effect of pH (2-10) and coagulant dosage (60-600 mg. L-1) to the removal of synthetic Congo red wastewater and sludge volume formation was investigated. It was found that pH 3.0 was the best pH for coagulation due to charge neutralization mechanism of leucaena protein. Furthermore the highest removal was obtained at dosage 420mg. L-1 with 80% removal. This result was comparable with crude extract of leucaena with half settling time (20 min) and lower increase of permanganate value.

Citrate-controlled chemical solution deposition of PbSe thin films

Trisodium citrate profoundly affects chemical solution deposition of PbSe thin films. Variation of citrate concentration allows control over grain size, and consequently, over photoluminescence emission from the films.