Regional citrate anticoagulation in renal replacement therapy in the intensive care station : Recommendations from the renal section of the DGIIN, ÖGIAIN and DIVI

Journal article


Publication Details

Author(s): Schmitz M, Joannidis M, Czock D, John S, Joerres A, Klein SJ, Oppert M, Schwenger V, Kielstein J, Zarbock A, Kindgen-Milles D, Willam C
Journal: Medizinische Klinik - Intensivmedizin und Notfallmedizin
Publication year: 2018
Volume: 113
Journal issue: 5
Pages range: 377-383
ISSN: 2193-6218
eISSN: 2193-6226


Abstract

BACKGROUND: Regional citrate anticoagulation (RCA) in continuous renal replacement therapy can effectively anticoagulate dialysis circuits without having adverse effects on systemic heparin application. In particular, in continuous renal replacement therapy RCA is well established and represents a safe procedure with longer filter lifetimes and fewer bleeding complications.
OBJECTIVES: To provide guidance on the indications, advantages and disadvantages, and use of RCA, current recommendations from the renal section of the DGIIN (Deutschen Gesellschaft für Internistische Intensivmedizin und Notfallmedizin), ÖGIAIN (Österreichischen Gesellschaft für Internistische und Allgemeine Intensivmedizin und Notfallmedizin) and DIVI (Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin) are stated.
MATERIALS AND METHODS: The recommendations in this paper are based on the current KDIGO (Kidney Disease: Improving Global Outcomes) guidelines, other published guidelines and protocols as well as the expert knowledge and clinical experience of the authors.
RESULTS: The use of commercially available machines with coupled pumps and integrated safety features, effective personal training and standardized protocols for clinical usage (SOP) is particularly important for the safe clinical use of RCA in renal replacement therapy. Contrary to previous recommendations, even liver failure or shock with lactic acidosis may no longer be an absolute contra-indication for RCA. However, these particular patients have to be carefully monitored for signs of citrate accumulation.


FAU Authors / FAU Editors

Willam, Carsten Prof. Dr.
Medizinische Klinik 4 - Nephrologie und Hypertensiologie


Additional Organisation
Medizinische Klinik 4 - Nephrologie und Hypertensiologie


External institutions with authors

Heinrich-Heine-Universität Düsseldorf
Klinikum Ernst von Bergmann
Klinikum Stuttgart
Krankenhaus Köln-Merheim - Klinikum der Universität Witten/Herdecke
Medizinische Universität Innsbruck
Städtisches Klinikum Braunschweig
Städtisches Klinikum Solingen
Universitätsklinikum Heidelberg
Universitätsklinikum Münster


How to cite

APA:
Schmitz, M., Joannidis, M., Czock, D., John, S., Joerres, A., Klein, S.J.,... Willam, C. (2018). Regional citrate anticoagulation in renal replacement therapy in the intensive care station : Recommendations from the renal section of the DGIIN, ÖGIAIN and DIVI. Medizinische Klinik - Intensivmedizin und Notfallmedizin, 113(5), 377-383. https://dx.doi.org/10.1007/s00063-018-0445-7

MLA:
Schmitz, M., et al. "Regional citrate anticoagulation in renal replacement therapy in the intensive care station : Recommendations from the renal section of the DGIIN, ÖGIAIN and DIVI." Medizinische Klinik - Intensivmedizin und Notfallmedizin 113.5 (2018): 377-383.

BibTeX: 

Last updated on 2018-12-11 at 11:08