[Regional citrate anticoagulation during continuous hemofiltration in cardiosurgical patients]

Different citrate anticoagulation protocols are widely used during continuous renal replacement therapy. The investigation was to study the efficiency and safety of citrate coagulation in patients after cardiovascular interventions. Thirty-eight patients underwent continuous hemofiltration (CHF) with anticoagulation with 0.2% Prismocitrate 10/2 solution by the protocol of the company (Gambra Medical) after operations on the heart and large vessels. The clinical data, changes in azotemia, blood electrolytes and gases, as well as the mean values of citrate anticoagulation, and mean hemofilter life span were studied. The mean duration of citrate anticoagulation was 68 +/- 13.7 hours and its maximum duration wa 18 days. Predilution administration of Prismocitrate 10/2 along with postdilution replacement with routine solutions ensured the CHF dose of 35 ml/kg/hr. But for terminal conditions, volume metabolic control and effective anticoagulation were achieved without negative metabolic sequels and clinical complications. The mean life span of a hemofilter, with its mandatory replacement every 35-48 hours, was 40 hours. It is concluded that Prismocitrate 10/2 anticoagulation is an effective, safe, and easy-to-use method for CHF after cardiosurgical operations, which may be widely recommended when use of heparin is contraindicated.