枸橼酸钠抗凝在老年日间连续性静脉-静脉血液透析中的效果观察

doi:10.3969/j.issn.1003-9198.2024.06.006

Abstract

Abstract: Objective To investigate and evaluate the efficacy and safety of regional citrate anticoagulation (RCA) in elderly patients undergoing daytime continuous venovenous hemodialysis (CVVHD). Methods A total of fifty elderly patients who received daytime RCA-CVVHD treatment from March 2022 to February 2023 in Blood Purification Center, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology were studied retrospectively. Renal function and electrolytes were detected before and after the treatment, and the venous blood gas indicators of the extracorporeal circulation were monitored during the treatment process.The clotting grade of the filter and extracorporeal circulation pipeline was recorded after the treatment. Results (1) All CVVHD in the 50 patients were successfully completed, with no coagulation occurring in the filters and venous pots. (2) The level of ionized calcium (iCa²⁺) after the filter one hour after the treatment was (0.36±0.05) mmol/L.(3) The blood iCa²⁺ level was decreased(P<0.05), while the levels of pH, bicarbonate ion (HCO₃^-), base excess (BE) were increased 2 and 5 h after treatment compared to pre-treatment levels(P<0.05).Sodium ion (Na⁺) level showed no significant change (P>0.05).(4) The levels of blood urea nitrogen (BUN), serum creatinine (Cr), potassium ion(K⁺), chloride ion(Cl^-), blood phosphate (P) and calcium(Ca²⁺) were decreased, while the level of HCO₃^-was increased after treatment (P<0.05). There was no significant change in Na⁺ level after treatment (P>0.05).(5) There was one case of sodium citrate accumulation during the treatment process. Conclusions The application of daytime RCA-CVVHD in elderly patients is safe and effective. To avoid sodium citrate accumulation or overdose, dynamic monitoring of venous blood gas indicator is necessary during treatment.

Key words: continuous renal replacement therapy, aged, regional citrate anticoagulation

CLC Number:

R495.5

LIU Ziyun, LI Ningxu. Efficacy and safety of regional citrate anticoagulation during daily continuous venovenous hemodialysis in elderly patients[J]. Practical Geriatrics, 2024, 38(6): 564-567.

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Efficacy and safety of regional citrate anticoagulation during daily continuous venovenous hemodialysis in elderly patients

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