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Related Concept Videos

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Related Experiment Video

Updated: Feb 12, 2026

Author Spotlight: Hickman Catheter Use for Long-Term Vascular Access in a Preclinical Swine Model
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Evolution of Vascular Access and Anticoagulation.

Patrick M Honore, Herbert D Spapen

    Contributions to Nephrology
    |March 30, 2018
    PubMed
    Summary

    Continuous renal replacement therapy (CRRT) requires proper vascular access and anticoagulation. Regional citrate anticoagulation (RCA) offers advantages over unfractionated heparin (UFH) but needs careful monitoring for metabolic effects.

    Area of Science:

    • Nephrology
    • Critical Care Medicine

    Background:

    • Continuous renal replacement therapy (CRRT) is vital for critically ill patients.
    • Effective CRRT depends on appropriate vascular access and circuit anticoagulation.

    Purpose of the Study:

    • To review vascular access options and anticoagulation strategies for CRRT.
    • To compare unfractionated heparin (UFH) with regional citrate anticoagulation (RCA).

    Main Methods:

    • Review of current literature on CRRT vascular access and anticoagulation.
    • Comparison of UFH and RCA efficacy, safety, and circuit survival.

    Main Results:

    • Right internal jugular vein is preferred for CRRT access; femoral veins are alternatives.
    • RCA offers improved circuit survival and safety in bleeding-risk patients compared to UFH.

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  • RCA necessitates monitoring for metabolic disturbances.
  • Conclusions:

    • Vascular access and anticoagulation are critical for CRRT success.
    • RCA represents a significant advancement in CRRT anticoagulation, despite requiring vigilant monitoring.
    • Future research should focus on improved catheter technology and citrate solutions.