Complications of regional citrate anticoagulation: accumulation or overload?
Abstract Regional citrate anticoagulation (RCA) is now recommended over systemic heparin for continuous renal replacement therapy in patients without contraindications. Its use is likely to increase throughout the world. However, in the absence of citrate blood level monitoring, the diagnosis of cit...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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BMC
2017-11-01
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| Series: | Critical Care |
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| Online Access: | http://link.springer.com/article/10.1186/s13054-017-1880-1 |
| _version_ | 1819076452085137408 |
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| author | Antoine G. Schneider Didier Journois Thomas Rimmelé |
| author_facet | Antoine G. Schneider Didier Journois Thomas Rimmelé |
| author_sort | Antoine G. Schneider |
| collection | DOAJ |
| description | Abstract Regional citrate anticoagulation (RCA) is now recommended over systemic heparin for continuous renal replacement therapy in patients without contraindications. Its use is likely to increase throughout the world. However, in the absence of citrate blood level monitoring, the diagnosis of citrate accumulation, the most feared complication of RCA, remains relatively complex. It is therefore commonly mistaken with other conditions. This review aims at providing clarifications on RCA-associated acid-base disturbances and their management at the bedside. In particular, the authors wish to propose a clear distinction between citrate accumulation and net citrate overload. |
| first_indexed | 2024-12-21T18:41:31Z |
| format | Article |
| id | doaj.art-f3cfee0f20d94894b9c7dda26691789e |
| institution | Directory Open Access Journal |
| issn | 1364-8535 |
| language | English |
| last_indexed | 2024-12-21T18:41:31Z |
| publishDate | 2017-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Critical Care |
| spelling | doaj.art-f3cfee0f20d94894b9c7dda26691789e2022-12-21T18:54:00ZengBMCCritical Care1364-85352017-11-012111710.1186/s13054-017-1880-1Complications of regional citrate anticoagulation: accumulation or overload?Antoine G. Schneider0Didier Journois1Thomas Rimmelé2Adult Intensive Care Unit, Centre Hospitalier Universitaire Vaudois (CHUV)Anesthesiology and Intensive Care Medicine, Cochin Hospital, Assistance Publique Hôpitaux de Paris, René Descartes UniversityAnesthesiology and Intensive Care Medicine, Edouard Herriot Hospital, Hospices Civils de LyonAbstract Regional citrate anticoagulation (RCA) is now recommended over systemic heparin for continuous renal replacement therapy in patients without contraindications. Its use is likely to increase throughout the world. However, in the absence of citrate blood level monitoring, the diagnosis of citrate accumulation, the most feared complication of RCA, remains relatively complex. It is therefore commonly mistaken with other conditions. This review aims at providing clarifications on RCA-associated acid-base disturbances and their management at the bedside. In particular, the authors wish to propose a clear distinction between citrate accumulation and net citrate overload.http://link.springer.com/article/10.1186/s13054-017-1880-1Regional citrate anticoagulationContinuous renal replacement therapyAcute kidney injuryCitrate accumulationComplications of therapyMetabolic alkalosis |
| spellingShingle | Antoine G. Schneider Didier Journois Thomas Rimmelé Complications of regional citrate anticoagulation: accumulation or overload? Critical Care Regional citrate anticoagulation Continuous renal replacement therapy Acute kidney injury Citrate accumulation Complications of therapy Metabolic alkalosis |
| title | Complications of regional citrate anticoagulation: accumulation or overload? |
| title_full | Complications of regional citrate anticoagulation: accumulation or overload? |
| title_fullStr | Complications of regional citrate anticoagulation: accumulation or overload? |
| title_full_unstemmed | Complications of regional citrate anticoagulation: accumulation or overload? |
| title_short | Complications of regional citrate anticoagulation: accumulation or overload? |
| title_sort | complications of regional citrate anticoagulation accumulation or overload |
| topic | Regional citrate anticoagulation Continuous renal replacement therapy Acute kidney injury Citrate accumulation Complications of therapy Metabolic alkalosis |
| url | http://link.springer.com/article/10.1186/s13054-017-1880-1 |
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