Article
Engineering, Biomedical
Zhen Hu, Junnan Xu, Yanyan Gong, Chenfu Gan, Tin Jiang, Xiaoling Wu, Yanyun Jiang, Tiantian Xiong, Jiayu Deng, Yiqun Zhong, Menglin Zou, Laimin Luo
Summary: The study investigated non-anticoagulant factors that affect blood coagulation in the extracorporeal circulation (ECC) circuit of regional citrate anticoagulation (RCA) protocol for hemodialysis (HD). The clinical characteristics were collected from patients undergoing individualized RCA protocol for HD, and factors such as coagulation scores, pressures in various parts of the ECC circuit, incidence of coagulation, and citrate concentrations were analyzed. The results showed that factors such as coagulation status, vascular access, dialyzer selection, and operator quality can affect the anticoagulant effect in the process of citrate anticoagulant hemodialysis.
INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS
(2023)
Article
Medicine, General & Internal
Laimin Luo, Meirong Fan, Qinkai Chen, Jing Cheng
Summary: The study validated the safety and efficacy of a simplified individualized RCA protocol for hemodialysis, showing that it is cost-effective, safe, and easy to implement in clinical practice.
Article
Multidisciplinary Sciences
Livia Whiting, Nathan Bianchi, Mohamed Faouzi, Antoine Schneider
Summary: This study aimed to evaluate the dynamics and factors associated with decreased membrane performance in continuous kidney replacement therapy (CKRT). Mixed-effects logistic regression model analyses showed that time significantly affected these values and identified independent predictors of decreased membrane performance. Additionally, COVID-19 infection was not associated with an increased risk of decreased membrane performance.
SCIENTIFIC REPORTS
(2023)
Article
Urology & Nephrology
Harmony H. M. To, Arthur M. C. Kwan, Natalie Y. Y. Leung, W. M. Chan, C. W. Ngai, Alfred S. K. Wong, Polly N. W. Tsai, Tammy S. K. Ma, Irene Yam, Pauline Yeung Ng, Desmond Y. H. Yap
Summary: This prospective study examined the diagnostic and predictive value of serum citrate levels for citrate accumulation (CA) in patients receiving regional citrate anticoagulation (RCA) continuous renal replacement therapy (CRRT). The study found that serum citrate levels showed good performance in diagnosing and predicting the development of CA.
CLINICAL KIDNEY JOURNAL
(2023)
Article
Critical Care Medicine
Nina Buchtele, Michael Schwameis, Peter Schellongowski, Peter Quehenberger, Paul Knoebl, Ludwig Traby, Monika Schmid, Christian Schoergenhofer, Harald Herkner, Bernd Jilma, Thomas Staudinger
Summary: A high prevalence of reduced coagulation factor XII activity was observed in adult patients on extracorporeal membrane oxygenation, with lower activity associated with fewer thromboembolic complications. Coagulation factor XII activity may confound activated partial thromboplastin time measurements and potentially serve as a target for anticoagulation in ECMO.
CRITICAL CARE MEDICINE
(2021)
Article
Medicine, Research & Experimental
Felix R. De Bie, Francesca M. Russo, Pieter Van Brantegem, Barbara E. Coons, James K. Moon, Zexuan Yang, Chengcheng Pang, Janaina C. Senra, Camilla Omann, Pieter Annaert, Karel Allegaert, Marcus G. Davey, Alan W. Flake, Jan Deprest
Summary: Sildenafil induced immediate and temporary pulmonary vascular and systemic hemodynamic changes in fetal lambs on extracorporeal support, without causing fetal acidosis. A dose of 0.5 mg/kg/24 h resulted in rapid attainment of target concentrations with short-lived systemic effects.
BIOMEDICINE & PHARMACOTHERAPY
(2021)
Article
Hematology
Litao Guo, Yu Liu, HaiRong Zheng, Qindong Shi, Gang Wang
Summary: This study analyzed the anticoagulation effect of different local infusion methods of citrate in critically ill patients undergoing CRRT. The modified group had longer treatment time, lower transmembrane pressure, fewer citrate bag replacements, and more stable ionized calcium levels compared to the conventional group. The incidences of citrate accumulation and tubing coagulation were marginally lower in the modified group.
THERAPEUTIC APHERESIS AND DIALYSIS
(2023)
Article
Biochemistry & Molecular Biology
Xiaoyan Tang, Dezheng Chen, Ling Zhang, Ping Fu, Yanxia Chen, Zhou Xiao, Xiangcheng Xiao, Weisheng Peng, Li Cheng, Yanmin Zhang, Hongbo Li, Kehui Li, Bizhen Gou, Xin Wu, Qian Yu, Lijun Jian, Zaizhi Zhu, Yu Wen, Cheng Liu, Hen Xue, Hongyu Zhang, Xin He, Bin Yan, Liping Zhong, Bin Huang, Mingying Mao
Summary: The two-stage regional citrate anticoagulation combined with sequential anticoagulation and standard calcium-containing dialysate can effectively reduce clotting events during hemodialysis, prolong dialysis time, with no significant difference in urea clearance compared to saline flushing.
JOURNAL OF ZHEJIANG UNIVERSITY-SCIENCE B
(2022)
Article
Multidisciplinary Sciences
Peerapat Thanapongsatorn, Weerachai Chaijamorn, Phatadon Sirivongrangson, Sasipha Tachaboon, Sadudee Peerapornratana, Nuttha Lumlertgul, Aroonrut Lucksiri, Nattachai Srisawat
Summary: This prospective clinical study evaluated the pharmacokinetics and metabolism of citrate in liver failure patients receiving continuous renal replacement therapy (CRRT) with regional citrate anticoagulation (RCA). The results showed a significantly decreased citrate clearance in these patients, raising concerns about the risk of citrate toxicity when using citrate as an anticoagulant.
SCIENTIFIC REPORTS
(2022)
Article
Critical Care Medicine
Christophe Leroy, Bruno Pereira, Edouard Soum, Claire Bachelier, Elisabeth Coupez, Laure Calvet, Konstantinos Bachoumas, Claire Dupuis, Bertrand Souweine, Alexandre Lautrette
Summary: Regional citrate anticoagulation is effective and safe during intermittent hemodialysis in ICU, but it does not improve efficacy compared to heparin anticoagulation. There is a potential increased risk of circuit clotting with RCA. Randomized trials are needed to determine the best anticoagulation strategy for IHD in ICU patients.
ANNALS OF INTENSIVE CARE
(2021)
Review
Pediatrics
Carlos Carmona, Marianne E. E. Nellis, Oliver Karam
Summary: The purpose of this review is to discuss the hemostatic changes induced by ECMO, the balance between bleeding and clotting risks, and the risks associated with anticoagulation and hemostatic transfusions. Recent findings suggest that anti-Xa-guided strategies may decrease bleeding complications without increasing clotting events. However, further research is needed to confirm these results in randomized controlled trials.
CURRENT OPINION IN PEDIATRICS
(2023)
Article
Pediatrics
Jun Hu, Chunxiao Wang, Ke Bai, Chengjun Liu
Summary: This study retrospectively analyzed the clinical application of RCA-mTPE in children with liver failure. The results showed that with proper protocol adjustment, RCA-mTPE can be used safely and effectively in these patients.
FRONTIERS IN PEDIATRICS
(2023)
Article
Urology & Nephrology
Wei Wang, Shaoyan Zhang, Yuehong Li, Xianglan Wu, Hua Yang, Jiaxuan Lv, Huiying Xu, Chong Wang
Summary: Simplified regional citrate anticoagulation hemodialysis is a safe, simple, and effective method for hemodialysis, where citrate dosage can be adjusted by monitoring serum Ca2+ level at 2 hours post-filter during dialysis. A blood flow rate of 200 mL/min, dialysate flow rate of 500 mL/min, and 1.5 mmol/L calcium dialysate are much safer for hemodialysis patients with a high risk of bleeding.
CLINICAL NEPHROLOGY
(2022)
Article
Engineering, Biomedical
Xin Song, Haifeng Ji, Yupei Li, Yuqin Xiong, Li Qiu, Rui Zhong, Meng Tian, Jayachandran N. Kizhakkedathu, Baihai Su, Qiang Wei, Weifeng Zhao, Changsheng Zhao
Summary: Hydrogel microspheres adsorbing coagulation factors can provide transient blood-thinning in extracorporeal circulation, promoting faster recovery of hemostasis and potentially increasing the safety of clinical blood-purification procedures.
NATURE BIOMEDICAL ENGINEERING
(2021)
Article
Medicine, General & Internal
Beong Ki Kim, Jeong In Hong, Jinwook Hwang, Hong Ju Shin
Summary: This study aimed to investigate the relationship between targeting low activated clotting time (ACT) and complication rates in patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR). The study found that maintaining ACT levels lower than conventional levels did not significantly increase the risk of thromboembolism in patients requiring ECPR.
