%0 Journal Article
%A Prada Rico, Mayerly
%A Fernández Sarmiento, Jaime
%A Rojas Velasquez, Ana María
%A González Chaparro, Luz Stella
%A Gastelbondo Amaya, Ricardo
%A Mulett Hoyos, Hernando
%A Tibaduiza, Daniel
%A Quintero Gómez, Ana Maria
%8 2017
%@ 1432-198X
%U http://hdl.handle.net/10818/37145
%X Background Anticoagulation of the continuous renal replacement therapy (CRRT) circuit is an important technical aspect
of this medical procedure. Most studies evaluating the efficacy
and safety of citrate use have been carried out in adults, and little
evidence is available for the pediatric patient population. The
aim of this study was to compare regional citrate anticoagulation
versus systemic heparin anticoagulation in terms of the lifetime
of hemofilters in a pediatric population receiving CRRT at a
pediatric center in Bogota, Colombia.
Methods This was an analytical, observational, retrospective cohort study in which we assessed the survival of 150 hemofilters
(citrate group 80 hemofilters, heparin group 70 hemofilters) used
in a total of 3442 hours of CCRT (citrate group 2248 h, heparin
group 1194 h). Hemofilter survival was estimated beginning at
placement and continuing until filter replacement due to clotting
or high trans-membrane pressures.
Results Hemofilter survival was higher in the citrate group than
in the heparin group (72 vs. 18 h; p <0.0001). Bivariate analysis
showed that the hemofilter coagulation risk was significantly
increased when heparin was used, regardless of hemofilter size
and pump flow (hazard ratio 3.70, standard error 0.82, 95%
confidence interval 2.39–5.72; p <0.00001).
Conclusions Regional citrate anticoagulation could be more
effective than heparin systemic anticoagulation in terms of
prolonging the hemofilter lifetime in patients with acute renal
injury who require CRRT.
%I Pediatric Nephrology
%K Anticoagulation
%K Citrate
%K Heparin
%K Continuous renal replacement therapy
%K Dialysis
%K Children
%T Regional citrate anticoagulation for continuous renal replacement therapy in children
%R 10.1007/s00467-016-3544-9
%~ Intellectum