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Review
. 2017 Feb;56(1):28-30.
doi: 10.1016/j.transci.2016.12.013. Epub 2016 Dec 30.

Citrate pathophysiology and metabolism

Mehran Monchi  1
Affiliations
Review

Citrate pathophysiology and metabolism

Mehran Monchi. Transfus Apher Sci. 2017 Feb.

Abstract

By chelating ionized calcium, citrate allows extracorporeal circuit anticoagulation without a bleeding risk for the patient. Citrate anticoagulation is also associated with a reduced activation of leucocytes and platelets. Citrate clearance by citric acid cycle (Krebs cycle) is not modified by renal failure, but is reduced by about 50% in patients with cirrhosis. Toxic effects of citrate result from a decrease in plasma ionized calcium of the patient. The first side effect is a prolongation of the QT interval. Clinical signs of hypocalcemia and hypotension in humans appear below 0.9mmol/L of plasma ionized calcium.

Keywords: Anticoagulation; Citrate; Extra corporeal circuits; Pharmacodynamics; Toxicity.

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