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Observational Study
. 2022 Sep 1;23(9):e429-e433.
doi: 10.1097/PCC.0000000000002993. Epub 2022 May 17.

Semiautomated Regional Citrate Anticoagulation for Continuous Kidney Replacement Therapy: An Observational Study in Young Children

Jean-Michel Liet  1 , Julien Baleine  2 , Pierre Demaret  3 , Sophie Mounier  2 , Florence Porcheret  4 , Nicolas Joram  1 , Alexis Chenouard  1
Affiliations
Observational Study

Semiautomated Regional Citrate Anticoagulation for Continuous Kidney Replacement Therapy: An Observational Study in Young Children

Jean-Michel Liet et al. Pediatr Crit Care Med. .

Abstract

Objectives: To review use of semiautomated regional citrate anticoagulation (saRCA) for continuous kidney replacement therapy (CKRT) in young children.

Design: Retrospective cohort study.

Setting: Three independent PICUs.

Patients: All consecutive children weighing less than 11 kg who received CKRT with saRCA from January 2015 to June 2020.

Interventions: None.

Measurements and main results: Twenty-one children weighing less than 11 kg underwent CKRT with saRCA. The total duration of the CKRT was 2,014 hours, with a total of 64 CKRT sessions. Citrate intoxication occurred in four of 64 CKRT sessions (6%). Citrate intoxication was consistently observed in the few CKRT sessions where the initial lactate concentration was greater than 4 mmol/L or the ratio of replacement fluid flow to citrate flow less than 50%. The rate of unscheduled interruptions of CKRT sessions was 25% (16/64).

Conclusions: We have used saRCA for CKRT in children weighing less than 11 kg. A strict protocol and intensive training are required to minimize complications.

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Conflict of interest statement

The authors have disclosed that they do not have any potential conflicts of interest.

References

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