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Complications of regional citrate anticoagulation: accumulation or overload?

  • Schneider AG Adult Intensive Care Unit, Centre Hospitalier Universitaire Vaudois (CHUV), 46 avenue du Bugnon, 1011, Lausanne, Switzerland. antoine.schneider@chuv.ch.
  • Journois D Anesthesiology and Intensive Care Medicine, Cochin Hospital, Assistance Publique Hôpitaux de Paris, René Descartes University, Paris, France.
  • Rimmelé T Anesthesiology and Intensive Care Medicine, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.
  • 2017-11-20
Published in:
  • Critical care (London, England). - 2017
Acute kidney injury
Citrate accumulation
Complications of therapy
Continuous renal replacement therapy
Metabolic alkalosis
Regional citrate anticoagulation
Acid-Base Equilibrium
Acute Kidney Injury
Anticoagulants
Citric Acid
Humans
Intensive Care Units
Renal Replacement Therapy
English Regional citrate anticoagulation (RCA) is now recommended over systemic heparin for continuous renal replacement therapy in patients without contraindications. Its use is likely to increase throughout the world. However, in the absence of citrate blood level monitoring, the diagnosis of citrate accumulation, the most feared complication of RCA, remains relatively complex. It is therefore commonly mistaken with other conditions. This review aims at providing clarifications on RCA-associated acid-base disturbances and their management at the bedside. In particular, the authors wish to propose a clear distinction between citrate accumulation and net citrate overload.
Language
  • English
Open access status
gold
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Persistent URL
https://sonar.rero.ch/global/documents/78815
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