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Outcomes of Continuous Renal Replacement Therapy With Regional Citrate Anticoagulation in Small Children After Cardiac Surgery: Experience and Protocol From a Single Center
Author(s) -
Musielak Anna,
Warzywoda Alfred,
Wojtalik Michał,
Kociński Bartłomiej,
Kroll Paweł,
OstalskaNowicka Danuta,
Zachwieja Jacek
Publication year - 2016
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/1744-9987.12456
Subject(s) - medicine , renal replacement therapy , acute kidney injury , activated clotting time , cardiopulmonary bypass , cardiac surgery , heparin , single center , aortic cross clamp , surgery , retrospective cohort study , critically ill , anesthesia , intensive care medicine
Patients after a cardiac surgery in cardiopulmonary bypass often present an acute kidney failure. Continuous renal replacement therapy (CRRT) is often required. The aim of this study was to present effectiveness and safety of CRRT with regional citrate anticoagulation (RCA‐CRRT) in small children after cardiac surgery. A retrospective analysis was conducted on 15 patients after cardiac surgery and who had RCA‐CRRT performed in 2014. The established protocol was followed. Mean time on the RCA‐CRRT was 192 h 40 min with the circuit mean lifetime of 43 h 33 min. Clotting was found to be a cause of shutdown in 29% of circuits. No severe electrolyte and metabolic disorders were observed. The RCA‐CRRT is a safe procedure for critically ill children with contraindications to the CRRT with heparin anticoagulation. To avoid adverse effects related to metabolic disorders a proper procedure protocol has to be followed.