A target-orientated algorithm for regional citrate-calcium anticoagulation in extracorporeal therapies.

Abstract:

BACKGROUND:Citrate anticoagulation offers several advantages in comparison to conventional anticoagulation. Most algorithms for regional citrate-calcium anticoagulation are based on citrate and calcium chloride infusion coupled in a fixed proportion to the blood flow without considering the hematocrit (Hct)/plasma flow or the filter clearance of citrate and calcium. METHODS:The aim of this study was to develop an algorithm for optimized citrate anticoagulation in extracorporeal therapies such as dialysis. A mathematical model was developed to calculate the volume of citrate infusion required to achieve a desired ionized calcium (iCa) target level in the extracorporeal circuit and to restore the total calcium level to a physiological value. RESULTS:The model was validated by correlation analyses for different blood Hct values and shows an excellent fit to the laboratory measurements. CONCLUSION:The results for both iCa target concentrations, namely those after citrate and calcium infusion, proved that the software algorithm adapts well to variable treatment parameters.

journal_name

Blood Purif

journal_title

Blood purification

authors

Brandl M,Strobl K,Hartmann J,Kellner K,Posnicek T,Falkenhagen D

doi

10.1159/000332394

subject

Has Abstract

pub_date

2012-01-01 00:00:00

pages

7-20

issue

1-3

eissn

0253-5068

issn

1421-9735

pii

000332394

journal_volume

33

pub_type

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