| The acid-base effect of changing citrate solution for regional anticoagulation during continuous veno-venous hemofiltration. | |
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MedLine Citation:
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PMID: 18373316 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To compare the acid-base balance effects of two different citrate doses for regional citrate anticoagulant (RCA) for continuous veno-venous hemofiltration (CVVH). METHODS: We used a commercial citrate fluid (citrate concentration: 11 mmol/L) from July 2003 to July 2004 (period A) in 22 patients; then changed to a new citrate fluid (citrate concentration: 14 mmol/L) from July 2004 to Feb 2005 (Period B) in 21 patients. Replacement fluid rate was fixed at 2,000 ml/h. We measured all relevant variables for acid-base analysis according to the Stewart-Figge methodology. RESULTS: After commencement of RCA-CVVH, there was a change in bicarbonate and base excess (BE) toward acidosis for both fluids. This change was significantly different between period A and B at 6 and 12 hours (pH: p<0.01, BE: p<0.05) with greater decreases with the 11 mmol/L citrate fluid. These changes were mostly secondary to an increase in the strong ion difference (SID) and occurred despite an increased strong ion gap (SIG) (+0.5 mEq/L vs. +1.5 mEq/L; p<0.01) in the higher citrate concentration fluid. Cessation of RCA-CVVH was associated with short-lived differences in bicarbonate and SIG which were similar to those seen on initiation of RCA-CVVH but in the opposite direction. CONCLUSIONS: A small increase This was partly offset by an increase in SIG, consistent with increased citratemia. Cessation of treatment showed a differential improvement in SIG also consistent with disposal of therapy-associated citrate. These observations might assist clinicians in interpreting acidbase changes during RCA-CVVH.in citrate infusion rate caused an alkalinizing increase in SID. |
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Authors:
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M Egi; T Naka; R Bellomo; C C Langenberg; W Li; N Fealy; I Baldwin |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The International journal of artificial organs Volume: 31 ISSN: 0391-3988 ISO Abbreviation: Int J Artif Organs Publication Date: 2008 Mar |
Date Detail:
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Created Date: 2008-03-31 Completed Date: 2008-07-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7802649 Medline TA: Int J Artif Organs Country: Italy |
Other Details:
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Languages: eng Pagination: 228-36 Citation Subset: IM |
Affiliation:
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Department of Intensive Care, University of Melbourne, Austin Hospital, Austin Health, Melbourne, Australia. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acid-Base Equilibrium
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physiology* Aged Anticoagulants / administration & dosage* Citric Acid / administration & dosage* Critical Illness Female Hemodialysis Solutions / administration & dosage* Hemofiltration / methods* Humans Kidney Failure, Acute / therapy Male Middle Aged |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants; 0/Hemodialysis Solutions; 77-92-9/Citric Acid |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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