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Título: Use of regional citrate anticoagulation for continuous venovenous hemodialysis in critically ill cancer patients with acute kidney injury
Autor: SILVA, Veronica Torres Costa eCAIRES, Renato AntunesBEZERRA, Juliana SilvaCOSTALONGA, Elerson C.OLIVEIRA, Ana Paula LeandroCOELHO, Fernanda OliveiraFUKUSHIMA, Julia T.SOARES, Cilene MunizOIKAWA, LucianeHAJJAR, Ludhmila AbrahaoBURDMANN, Emmanuel A.
Citación: JOURNAL OF CRITICAL CARE, v.47, p.302-309, 2018
Resumen: 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.
Aparece en las colecciones:

Artigos e Materiais de Revistas Científicas - FM/MCM
Departamento de Clínica Médica - FM/MCM

Artigos e Materiais de Revistas Científicas - FM/MCP
Departamento de Cardio-Pneumologia - FM/MCP

Artigos e Materiais de Revistas Científicas - HC/ICESP
Instituto do Câncer do Estado de São Paulo - HC/ICESP

Artigos e Materiais de Revistas Científicas - HC/InCor
Instituto do Coração - HC/InCor

Artigos e Materiais de Revistas Científicas - LIM/08
LIM/08 - Laboratório de Anestesiologia

Artigos e Materiais de Revistas Científicas - LIM/12
LIM/12 - Laboratório de Pesquisa Básica em Doenças Renais

Artigos e Materiais de Revistas Científicas - LIM/29
LIM/29 - Laboratório de Nefrologia Celular, Genética e Molecular

Artigos e Materiais de Revistas Científicas - ODS/03
ODS/03 - Saúde e bem-estar


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