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A target-oriented algorithm for citrate-calcium anticoagulation in clinical practice.

Karin Strobl1, Jens Hartmann, Manfred Wallner

  • 1Center for Biomedical Technology, Danube University Krems, Krems, Austria.

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|November 13, 2013
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Summary
This summary is machine-generated.

A new semi-automated algorithm for regional citrate anticoagulation (RCA) was developed and evaluated. This system safely and accurately controls anticoagulation during dialysis by regulating pre-filter calcium levels.

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Area of Science:

  • Nephrology
  • Biomedical Engineering

Background:

  • High monitoring demand necessitates automation in regional citrate anticoagulation (RCA).
  • A novel semi-automated, target-oriented algorithm for RCA was developed.

Purpose of the Study:

  • To evaluate the functionality and safety of the new semi-automated RCA algorithm.
  • To assess the algorithm's ability to manage anticoagulation during hemodialysis.

Main Methods:

  • Fourteen hemodialysis patients underwent 5 consecutive RCA treatments.
  • Hourly pre- and post-infusion blood samples were analyzed for electrolytes, cell counts, acid-base, and coagulation parameters.

Main Results:

  • Mean pre-filter ionized calcium (Ca2+) levels were maintained within target ranges (0.23-0.33 mmol/l).
  • Consistent extraction ratios for citrate (83%) and total calcium (68%) were observed across the dialysis filter.
  • No citrate accumulation occurred during treatment.

Conclusions:

  • The new algorithm provides safe and accurate regional citrate anticoagulation.
  • Regulating pre-filter Ca2+ with the target-oriented algorithm allows for precise control of anticoagulation intensity.