摘要
Abstract
Objective To assess the efficacy and safety of local citrate anticoagulation in the process of continuous veno-venous hemofiltration(CVVH) for acute kidney injury(AKI) patients in ICU.Methods We searched the Pubmed,EMBASE,CNKI,VIP,CBM,and Cochrane library for randomized controlled trials(RCTs) that comparing the anticoagulate effects of local citrate and unfractionated heparin in CVVH up to April 2014.The RCTs were selected and assessed based on the inclusion and exclusion criteria,then the data was extracted for meta-analysis.Results Finally 4 RCTs with 258 patients met the inclusion criteria.The meta-analysis showed that local sodium citrate obviously decreased the incidence of bleeding(RR =0.25,95 ％ CI =0.09 ～ 0.68,P =0.006) and prolonged the service life of filter (M D =14.36,95 ％ CI =1.11 ～ 27.61,P =0.03),but the incidence of metabolic alkalosis (RR =0.89,95 ％ CI =0.16 ～ 4.96,P =0.90) and hypocalcemia (RR =4.44,95 ％ CI =0.76 ～ 25.83,P =0.10) was no significant differences between two groups.Conclusion Based on the current clinical evidence,local citrate may be more suitable for the patients with higher risk of bleeding and the treatment of CVVH,because of its advantages of reducing the rate of hemorrhage and extending the service life of filter.关键词
枸橼酸盐/肝素/抗凝/连续性静静脉血液滤过/系统评价Key words
Citrate / Heparin / Anticoagulation/ Continuous veno-venous hemofiltration/ Meta-analysis
