BackgroundCitrateisananticoagulantagentthathasshown.pptVIP

Background Citrate is an anticoagulant agent that has shown promise with favourable efficacy and safety profiles for use during continuous renal replacement therapy CRRT . These benefits have been well reported in the literature1. However, there has only been very limited number of studies comparing citrate to heparin, which is more commonly used in CRRT. Observational Study: Utilisation of Citrate Versus Heparin Anticoagulation for Continuous Renal Replacement Therapy in Intensive Care Unit May Reduce Patients Need for Blood Transfusion Joyce RY Chew, Victor Nwokocha, Andre Khoo, Andrew Mizen, Pejman Davoudian Department of Critical Care Medicine, West Suffolk Hospital, Bury St Edmunds, United Kingdom Objective As one of the first intensive care units within East of England to use citrate in place of heparin, we have conducted this study to compare the transfusion frequency and volume associated with using these agents. We excluded patients with active bleeding, pre-existing coagulopathy, previously known end stage renal failure and all surgical patients in our study. The ICU electronic records system Metavision was reviewed for patient demographics, cause of acute kidney injury, mean haemoglobin levels, transfusion frequency, transfusion volume and final outcome. Collected data was analysed using the standard t-test to determine significant differences in demographics, volume and frequency of transfusion and mean Hb. Fisher’s exact test was used to analyse the final outcome data. Results There was no significant difference in the mean APACHE score, age, mean haemoglobin level, length of treatment and mortality rate between treatment groups. Conclusion This study shows that citrate as a regional anticoagulant agent demonstrated benefits over heparin in CRRT with respect to the need for transfusion and the total number of units transfused. References: 1. Gerd R Hetzel, Michael Schmitz, Heimo Wissing et al. Regional citrate versus systemic heparin for anticoag