A comparison between two dilute citrate solutions (15 vs. 18 mmol/l) in continuous renal replacement therapy: the base excess and renal substitution solution study

Anstey, Chris, Campbell, Victoria and Richardson, Alexander (2016) A comparison between two dilute citrate solutions (15 vs. 18 mmol/l) in continuous renal replacement therapy: the base excess and renal substitution solution study. Blood Purification, 42 3: 194-201. doi:10.1159/000446979


Author Anstey, Chris
Campbell, Victoria
Richardson, Alexander
Title A comparison between two dilute citrate solutions (15 vs. 18 mmol/l) in continuous renal replacement therapy: the base excess and renal substitution solution study
Journal name Blood Purification   Check publisher's open access policy
ISSN 1421-9735
0253-5068
Publication date 2016-06-29
Year available 2016
Sub-type Article (original research)
DOI 10.1159/000446979
Open Access Status Not yet assessed
Volume 42
Issue 3
Start page 194
End page 201
Total pages 8
Place of publication Basel, Switzerland
Publisher S. Karger AG
Collection year 2017
Language eng
Formatted abstract
Background/Aims: The study aimed to compare the changes in biochemistry occurring in patients undergoing continuous renal replacement therapy (CRRT) using 2 trisodium citrate solutions, Baxter hemofiltration fluid containing 18 mmol/l (C18) and Baxter NamSol, a custom manufactured solution containing 15 mmol/l (C15), both delivered as regional citrate anticoagulation (RCA) predilution fluids for hemofiltration.

Methods: This is a prospective randomized control trial conducted in a major regional adult intensive care unit. Patients were randomized to 1 of 2 RCA fluids. Progress was monitored using a standard daily panel of acid-base and biochemical tests.

Results: Forty-eight patients, 23 C18 and 25 C15, were recruited. In both groups, acidosis resolved within 36 h of institution of CRRT. By day 3, there were significant differences in serum [Na+], standard base excess and serum bicarbonate concentration, all being higher in the C18 group (p < 0.01). By day 5, the PaCO2 had also risen in the C18 group (p = 0.03).

Conclusions: The C15 solution provided equivalent filter life to the C18 solution but without significant hypernatremia and metabolic alkalosis.
Keyword Continuous veno-venous hemofiltration
Metabolic alkalosis
Regional citrate anticoagulation
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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