Use of regional citrate anticoagulation for continuous venovenous hemodialysis in critically ill cancer patients with acute kidney injury

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art_SILVA_Use_of_regional_citrate_anticoagulation_for_continuous_venovenous_2018.PDF (430.35 KB)
Citações na Scopus
3
Tipo de produção
article
Data de publicação
2018
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
W B SAUNDERS CO-ELSEVIER INC
Autores
Citação
JOURNAL OF CRITICAL CARE, v.47, p.302-309, 2018
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Purpose: This study aimed to evaluate the safety and efficacy of a regional citrate anticoagulation (RCA) protocol for continuous venovenous hemodialysis (CVVHD) in cancer patients with acute kidney injury (AKI) in the intensive care unit (ICU) setting. Material and methods: One hundred twenty two consecutive ICU cancer patients with AKI treated with citrate-based CVVHD were prospectively evaluated in this prospective observational study. Results: A total of 7198 h of CVVHD therapy (250 filters) were performed. Patients were 613 +/- 15.7 years old, 78% had solid cancer and the main AKI cause was sepsis (50%). The in-hospital mortality was 78.7%. Systemic ionized calcium (SCai) was 435 (4.10-4.60) mg/dL, severe hypocalcemia (SCai <3.6 mg/dL) was observed in 4.3% of procedures and post-filter ionized calcium was 1.60 (1.40-1.80) mg/dL. Median filter pa tency was 24.8 (11-43) hours. Factors related to filter clotting were: no tumor evidence (OR 0.44, C10.18-0.99); genitourinary tumor (OR 1.83, CI 1.18-2.81); platelets number (each 10,000/mm(3)) (OR 1.02, CI 1.00-1.04); International Normatized Ratio (INR) (OR 059, CI 0.41-0.85) and citrate dose (each 10 mL/h) (OR 0.88, CI 0.82-0.95). Conclusion: Filler plenty was relatively short and dotting was associated with active cancer disease, genitourinary tumor, lower citrate dose and lower INR. (C) 2018 Published by Elsevier Inc.
Palavras-chave
Acute kidney injury, Continuous renal replacement therapy, Regional citrate anticoagulation, Cancer patients, Intensive care unit
URI
https://observatorio.fm.usp.br/handle/OPI/29384
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MCP
Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/08
Artigos e Materiais de Revistas Científicas - LIM/12
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