Management of regional citrate anticoagulation for continuous renal replacement therapy: guideline recommendations from Chinese emergency medical doctor consensus

Military Medical Research

Position article and Guideline

Yu-Guo Chen¹  Ding-Yu Tan²  Lu Yin³  Ting Yang⁴  Feng Sun⁵  Kui Jin⁶  Xiao-Dong Zhao⁷  Qiu-Bin Zhang⁸  Tian-Yu Xin⁹  Shu-Yuan Liu⁹  Xue-Zhong Yu^1,10  Jun Xu^1,10  Sheng-Yong Xu^1,10 

[1] Emergency Department and Chest Pain Center, Qilu Hospital of Shandong University, 100005, Jinan, China;Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, 100005, Jinan, China;Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Qilu Hospital of Shandong University, 100005, Jinan, China;Emergency Department, Northern Jiangsu People’s Hospital, Clinical Medical College of Yangzhou University, 225001, Yangzhou, China;Emergency Department, Peking University Shenzhen Hospital, 518000, Shenzhen, China;Emergency Department, The First Affiliated Hospital of Kunming Medical University, 650000, Kunming, China;Emergency Department, The First Affiliated Hospital of Nanjing Medical University, 210029, Nanjing, China;Emergency Department, The First Affiliated Hospital of University of Science and Technology of China, 230001, Hefei, China;Emergency Department, The Fourth Medical Center, Chinese PLA General Hospital, 100048, Beijing, China;Emergency Department, The Second Affiliated Hospital of Hainan Medical College, 570100, Haikou, China;Emergency Department, The Sixth Medical Center, Chinese PLA General Hospital, 100048, Beijing, China;State Key Laboratory of Complex Severe and Rare Diseases, Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, 100730, Beijing, China;

关键词: Continuous renal replacement therapy;    Emergency;    Anticoagulation;    Citrate;    Guideline;    Expert consensus;   

DOI  :  10.1186/s40779-023-00457-9

 received in 2022-07-19, accepted in 2023-04-28,  发布年份 2023

来源: Springer

【 摘 要 】

Continuous renal replacement therapy (CRRT) is widely used for treating critically-ill patients in the emergency department in China. Anticoagulant therapy is needed to prevent clotting in the extracorporeal circulation during CRRT. Regional citrate anticoagulation (RCA) has been shown to potentially be safer and more effective and is now recommended as the preferred anticoagulant method for CRRT. However, there is still a lack of unified standards for RCA management in the world, and there are many problems in using this method in clinical practice. The Emergency Medical Doctor Branch of the Chinese Medical Doctor Association (CMDA) organized a panel of domestic emergency medicine experts and international experts of CRRT to discuss RCA-related issues, including the advantages and disadvantages of RCA in CRRT anticoagulation, the principle of RCA, parameter settings for RCA, monitoring of RCA (mainly metabolic acid–base disorders), and special issues during RCA. Based on the latest available research evidence as well as the paneled experts’ clinical experience, considering the generalizability, suitability, and potential resource utilization, while also balancing clinical advantages and disadvantages, a total of 16 guideline recommendations were formed from the experts’ consensus.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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