首页|期刊导航|中华医学杂志（英文版）|Regional citrate anticoagulation in critically ill patients during continuous blood purification
中华医学杂志（英文版）2003，Vol.116Issue(3)：360-363,4.
Regional citrate anticoagulation in critically ill patients during continuous blood purification
Regional citrate anticoagulation in critically ill patients during continuous blood purification
摘要
Abstract
Objectives To evaluate the safety and define the contraindication of regional citrate anticoagulation treatment on various critically ill patients being treated by continuous blood purification, who also had bleeding tendencies. Methods Forty critically ill patients being treated by continuous blood purification (CBP) were involved in this study. Due to their bleeding tendencies, regional citrate anticoagulation treatment was given to all of them. Those with hepatic function impairment (n=10) were classified as Group A, those with hypoxemia were classified as Group B (n=10), and the others as Group C (n=20). Blood samples were collected before treatment, and at 4, 12, 24, 36, and 48 hour intervals during CBP. These samples then were used arterial blood gas analysis, whole blood activated clotting time (WBACT) pre- and post-filter, and serum ionized calcium examination. Results WBACT pre-filter showed little fluctuant through the 48hr period of CBP, and WBACT post-filter showed obvious prolongation than that of the pre-filter (P<0.05) at all time points. Metabolic acidosis was found in Group A patients before CBP, and improved during CBP. Normal acid-base conditions of patients were disturbed and deteriorated in Group B during CBP, but not in Group C. Serum ionized calcium was maintained at a normal range during CBP in Group A and C patients, but declined significantly in Group B patients (vs. pre-treatment, P<0.05). Conclusions Regional citrate anticoagulation can be safely used in conjunction with CBP treatment for patients with hepatic function impairment , but may induce acidosis and a decline in serum ionized calcium when used with hypoxemic patients.关键词
continuous blood purification/regional citrate anticoagulation/complicationKey words
continuous blood purification/regional citrate anticoagulation/complication分类
医药卫生引用本文复制引用
龚德华,季大玺,徐斌,谢红浪,刘云,黎磊石..Regional citrate anticoagulation in critically ill patients during continuous blood purification[J].中华医学杂志（英文版）,2003,116(3):360-363,4.基金项目
This study was supported by PLA Tenth-Five-Year Study Plan (No. 01L007). （No. 01L007）
