期刊
CRITICAL CARE
卷 21, 期 -, 页码 -出版社
BIOMED CENTRAL LTD
DOI: 10.1186/s13054-017-1880-1
关键词
Regional citrate anticoagulation; Continuous renal replacement therapy; Acute kidney injury; Citrate accumulation; Complications of therapy; Metabolic alkalosis
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.
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