Anticoagulation of 4% sodium citrate for different modes of continuous blood purification

Objective To explore the effects of 4% sodium citrate for different modes of continuous blood purification(CBP).Methods Clinical data were retrospectively reviewed for 45 end-stage kidney disease patients with bleeding tendency or active bleeding.They were divided into two groups of A(n=22) and B(n=23).And all of them were anti-coagulated with 4% sodium citrate in vitro.Group A received continuous hemodiafiltration while group B had continuous hemofiltration.Both groups received base-free substitution fluid for 24 hours.Groups A and B were supplemented with peripheral base.The changes of blood creatinine, electrolyte, activated partial thromboplastin time(APTT), blood gas and calcium ion pre-filter were recorded before, during and after treatment.Coagulation status of filter and pipeline was observed.Results Both groups successfully completed 24-hour continuous blood purification.There was no onset of alkalosis, hypernatremia, hypocalcemic convulsion or lip numbness related to citrate anticoagulation.The adequacy of treatment was decent in both groups.And amount of base supplementation was significantly higher in group A than that in group B.Conclusions During 24-hour continuous blood purification, anticoagulation of 4% sodium citrate is both safe and efficacious.Less base supplement is required for continuous hemofiltration mode and it mimics closely the physiological mode.And continuous hemofiltration is worthy of a wider popularization.