The effectiveness and safety of regional citrate anticoagulation in intermittent haemodialysis/haemodiafiltration -- a systematic review.
Background: Haemodialysis requires anticoagulation to prevent thrombosis in the extracorporeal circuit (ECC), usually with heparin. However, systemic heparin anticoagulation is contraindicated when patients have active haemorrhage or bleeding risk or heparin-induced thrombocytopaenia type II. Region...
| Publicado en: | Renal Society of Australasia Journal Vol. 14; no. 2; pp. 39 - 52 |
|---|---|
| Autores principales: | , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Cambridge Publishing
Jul2018
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=130766972&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 130766972 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18323804 2WU1 jtl: Renal Society of Australasia Journal issn: 18323804 maglogo: N pubinfo: dt: Jul2018 vid: 14 iid: 2 pid: 66266 pub: Cambridge Publishing artinfo: ui: 130766972 130766972 130766972 130766972 ppf: 39 ppct: 13 formats: fmt: @attributes: type: P tig: atl: The effectiveness and safety of regional citrate anticoagulation in intermittent haemodialysis/haemodiafiltration -- a systematic review. aug: au: Aijun Fang Wiechula, Richard affil: Adelaide Nursing School, University of Adelaide, SA, Australia sug: subj: Citrates Therapeutic Use Hemodialysis Hemodiafiltration Dialysis Solutions Thrombosis Prevention and Control Human Systematic Review PubMed Embase CINAHL Database Cochrane Library Calcium Algorithms Fluid-Electrolyte Balance Acid-Base Equilibrium Nephrology Nursing Citrates Adverse Effects Citrates Blood Hypocalcemia Hypercalcemia ab: Background: Haemodialysis requires anticoagulation to prevent thrombosis in the extracorporeal circuit (ECC), usually with heparin. However, systemic heparin anticoagulation is contraindicated when patients have active haemorrhage or bleeding risk or heparin-induced thrombocytopaenia type II. Regional citrate anticoagulation (RCA) has been suggested by many studies as an effective and safe alternative anticoagulation in these situations. However, to the authors' best knowledge, there are no systematic reviews exploring the efficacy and safety of RCA in intermittent haemodialysis/haemodiafiltration (IHD/IHDF). Aim: The review intends to explore the effectiveness and safety of RCA in IHD/IHDF. Methods: A comprehensive literature search was conducted and 14 studies were included. Two reviewers critically appraised the articles and then extracted data. Narrative synthesis was conducted on the extracted data due to the outstanding heterogeneity among the included studies. Results: Conventional RCA with calcium-free dialysate was an effective alternative anticoagulation method in IHD. Mild metabolic derangement, especially asymptomatic hypocalcaemia, was common and severe metabolic complications were mainly caused by operational errors. However, RCA with calcium containing dialysate compromised anticoagulation in the ECC. Conclusions: Conventional RCA with calcium-free dialysate is an efficacious and relatively safe alternative anticoagulation method in IHD. Point of care monitoring of calcium is necessary to ensure efficacy and safety. pubtype: Academic Journal doctype: research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|