Regional citrate anticoagulation for continuous renal replacement therapy in newborns

作者全名："Huang, Haixia; Deng, Xing; Bai, Ke; Liu, Chengjun; Xu, Feng; Dang, Hongxing"

作者地址："[Huang, Haixia; Deng, Xing; Bai, Ke; Liu, Chengjun; Xu, Feng; Dang, Hongxing] Chongqing Med Univ, Cooperat Base Child Dev & Crit Disorders, China Int Sci & Technol, Intens Care Unit,Minist Educ,Chongqing Key Lab Ped, Chongqing, Peoples R China"

通信作者："Bai, K (通讯作者)，Chongqing Med Univ, Cooperat Base Child Dev & Crit Disorders, China Int Sci & Technol, Intens Care Unit,Minist Educ,Chongqing Key Lab Ped, Chongqing, Peoples R China."

来源：FRONTIERS IN PEDIATRICS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000954560100001

JCR分区：Q2

影响因子：2.1

年份：2023

卷号：11

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：citrate accumulation; continuous renal replacement therapy; newborns; regional citrate anticoagulation; critically ill

摘要："BackgroundRegional citrate anticoagulant (RCA) is recommended as the preferred anticoagulant regimen for continuous renal replacement therapy (CRRT) in adults; however, it is rarely reported in neonates due to concerns associated with their immature liver. Few studies have reported on the use of RCA to evaluate the safety and efficacy of RCA-CRRT in neonates.MethodIn this retrospective observational study, we reviewed the clinical records of neonates who underwent RCA-CRRT at our pediatric intensive care unit between September 2015 to January 2021.ResultsA total of 23 neonates underwent 57 sessions of RCA-CRRT. Their mean age was 10.1 +/- 6.9 days and mean weight was 3.0 +/- 0.7 kg (range, 0.95-4 kg). The mean filter life was 31.54 +/- 19.58 h (range, 3.3-72.5 h). Compared to pretreatment values, the total-to-ionized calcium ratio (T/iCa) on RCA-CRRT increased (2.00 +/- 34 0.36 vs. 2.19 +/- 0.40, P = 0.056) as did the incidence of T/iCa levels >2.5 (11.4 vs. 14.3, P = 0.477), albeit not significantly. Using a post-treatment T/iCa threshold of 2.5, we divided all the cases into citrate accumulation (CA) and non-CA (NCA) groups. Compared with the NCA group, the CA group had significantly higher body weight (3.64 +/- 0.32 kg vs. 2.95 +/- 0.41 kg, P = 0.033) and significantly lower blood flow rate per body weight ml/kg/min (3.08 +/- 0.08 vs. 4.07 +/- 0.71, P = 0.027); however, there was no significant difference between the two groups in terms of age, corrected gestational age, the PRISM-III score, and biochemical tests.ConclusionRCA-CRRT is safe and effective for neonates. After appropriate adjustments of the RCA-CRRT parameters, the incidence of CA was not higher in neonates than in children or adults, and CA was not found to be significantly correlated with age or corrected gestational age."

基金机构：Program for Youth Innovation in Future Medicine from Chongqing Medical University: Basic and Clinical Study of Critical Illness in Children [2021-W0111]

基金资助正文：Program for Youth Innovation in Future Medicine from Chongqing Medical University: Basic and Clinical Study of Critical Illness in Children (2021-W0111).