• Pediatr. Nephrol. · Mar 2014

    Comparative Study

    Citrate anticoagulation for continuous renal replacement therapy in small children.

    • Jolanta Soltysiak, Alfred Warzywoda, Bartłomiej Kociński, Danuta Ostalska-Nowicka, Anna Benedyk, Magdalena Silska-Dittmar, and Jacek Zachwieja.
    • Department of Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, Poznan, Poland, jsoltysiak1@gmail.com.
    • Pediatr. Nephrol. 2014 Mar 1; 29 (3): 469-75.

    BackgroundRegional citrate anticoagulation (RCA) is one of the methods used to prevent clotting in continuous renal replacement therapy (CRRT). The aim of this study was to describe the outcomes and complications of RCA-CRRT in comparison to heparin anticoagulation (HA)-CRRT in critically ill children.MethodsThis study was a retrospective review of 30 critically ill children (16 on RCA- and 14 on HA-CRRT) who underwent at least 24 h of CRRT. The mean body weight of the children was 8.69 ± 5.63 kg. RCA-CRRT was performed with a commercially available pre-dilution citrate solution (Prismocitrate 18/0).ResultsThe mean time on RCA-CRRT and HA-CRRT was 148.73 ± 131.58 and 110.24 ± 105.38 h, respectively. Circuit lifetime was significantly higher in RCA-CRRT than in HA-CRRT (58.04 ± 51.18 h vs. 37.64 ± 32.51 h, respectively; p = 0.030). Circuit clotting was observed in 11.63 % of children receiving RCA-CRRT and 34.15 % of those receiving HA-CRRT. Episodic electrolyte and metabolic disturbances were more common in children receiving RCA-CRRT. The survival at discharge from the hospital was 37.5 and 14.3 % among children receiving RCA-CRRT and HA-CRRT, respectively.ConclusionsIn critically ill children with a low body weight, RCA appeared to be safe and easy to used. Among our patient cohort, RCA was more effective in preventing circuit clotting and provided a better circuit lifetime than HA.

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