A Continuous Renal Replacement Therapy Protocol on the Updated Nikkiso Aquarius Platform Using Regional Citrate as First-Line Anticoagulation Significantly Improves Filter Life Span but the Position of the Vascular Access is Key

2017 ◽  
Vol 45 (1-3) ◽  
pp. 129-130 ◽  
Author(s):  
Christopher J. Kirwan ◽  
Louisa  Jackson ◽  
John R. Prowle
Keyword(s):  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Life Span ◽  
Replacement Therapy ◽  
Vascular Access ◽  
First Line ◽  
Filter Life ◽  
Therapy Protocol

scholarly journals Evaluating the safety and efficacy of regional citrate compared to systemic heparin as anticoagulation for continuous renal replacement therapy in critically ill patients: A service evaluation following a change in practice

2017 ◽  
Vol 18 (3) ◽  
pp. 184-192 ◽  
Author(s):  
Roberta Borg ◽  
Debra Ugboma ◽  
Dawn-Marie Walker ◽  
Richard Partridge
Keyword(s):  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Service Evaluation ◽  
First Year ◽  
First Line ◽  
Safety And Efficacy ◽  
Significant Difference ◽  
Change In Practice ◽  
Median Lifespan

Following the implementation of citrate anticoagulation for continuous renal replacement therapy, we evaluate its first year of use and compare it to the previously used heparin, to assess whether our patients benefit from the recently reported advantages of citrate. We retrospectively analysed 2 years of data to compare the safety and efficacy of citrate versus heparin. The results have shown that 43 patients received continuous renal replacement therapy with heparin, 37 patients with citrate. We found no significant difference in metabolic control of pH, urea and creatinine after 72 h. Filters anticoagulated with citrate had significantly longer median lifespan (33 h vs 17 h; p = 0.001), shorter downtime (0 h vs 5 h; p = 0.015) and less filter sets per patient day (0.37 vs 0.67; p = 0.002). Filters anticoagulated with heparin were commonly interrupted due to clotting (50% vs 16.4%), whereas filters anticoagulated with citrate were often stopped electively (53.4% vs 24.6%). Patients on heparin filters had significantly higher APPTs, some at potentially dangerous levels (>180 s), whilst patients on citrate filters had significantly higher levels of bicarbonate. Therefore, we conclude that citrate is superior in terms of safety and efficacy, with longer filter lifespan. It has become our first line anticoagulant for continuous renal replacement therapy.

scholarly journals Early mobilization on continuous renal replacement therapy is safe and may improve filter life

Critical Care ◽  
2014 ◽  
Vol 18 (4) ◽  
pp. R161 ◽  
Author(s):  
Yi Wang ◽  
Terry P Haines ◽  
Paul Ritchie ◽  
Craig Walker ◽  
Teri A Ansell ◽  
...  
Keyword(s):  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Early Mobilization ◽  
Filter Life

Do anti-platelet drugs improve duration of continuous renal replacement therapy? A retrospective cohort study in cardiac ICU patients

2021 ◽  
pp. 039139882110312
Author(s):  
Vivek Gupta ◽  
Naved Aslam ◽  
Shibba Takkar Chhabra ◽  
Vikas Makkar ◽  
Bishav Mohan ◽  
...  
Keyword(s):  
Cohort Study ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
North India ◽  
Filter Life ◽  
Anti Platelet Drug ◽  
The Impact

Objective: The objective of this study was to investigate the impact of anti-platelet drug/s on duration of continuous renal replacement therapy (CRRT) in those patients where anti-coagulants were not used due to certain contraindications and in cases where patients were on anti-platelet drugs and were given anti-coagulant during CRRT. Method: This single-center, retrospective cohort study was conducted using the medical records patients treated with CRRT in the cardiac ICU of the inpatient urban facility, located in North India. Data was collected from only those patients who received CRRT for the duration of at least 12 h. Patient’s in NAC group were not on any anti-platelet/s and did not receive anti-coagulant during CRRT. AC and AP group patients received anti-coagulant alone or were already on anti-platelet/s and did not receive anti-coagulant respectively while ACAP group patients were on anti-platelet drug/s and also received anti-coagulant during CRRT. Result: Patients in AC, AP, or ACAP group showed significantly ( p < 0.001) higher CRRT filter life compared to NAC group. The median CRRT filter life was significantly higher in the ACAP group compared to AC ( p < 0.05) and AP ( p < 0.001) groups. Conclusion: This study indicates that systemic anti-platelet therapy can provide additional support in critical patients undergoing CRRT even with or without anti-coagulant therapy. However, the increase in CRRT filter life was more profound in patients who were on anti-platelet/s and also received anti-coagulant drug/s during CRRT.

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