Validation of a Protocol for Continuous Hemodiafiltration with Regional Citrate Anticoagulation with Omni®.

Details

Serval ID
serval:BIB_17681018AD9F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Validation of a Protocol for Continuous Hemodiafiltration with Regional Citrate Anticoagulation with Omni®.
Journal
Blood purification
Author(s)
Whiting L., Bianchi N.A., Alouazen K., Joannes-Boyau O., Chiche J.D., Schneider A.
ISSN
1421-9735 (Electronic)
ISSN-L
0253-5068
Publication state
In Press
Peer-reviewed
Oui
Pages
1-9
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
Omni® (B Braun, Melsungen, Germany) is able to run continuous renal replacement therapy (CRRT) in continuous veno-venous hemofiltration (CVVH), hemodialysis (CVVHD), and hemodiafiltration (CVVHDF) modes. However, to date, there is no validated protocol to guide the use of Omni® in CVVHDF mode with regional citrate anticoagulation (RCA).
We designed a protocol for CVVHDF-RCA tailored for Omni®. This protocol was tested in patients included in an observational study conducted in our center between January and March 2021. For all study patients, we collected baseline characteristics, laboratory results, CRRT circuit lifespan as well as plasma and effluent samples at 12, 24, 48, and 72 h of CRRT circuit initiation. At each study time point, we computed urea, creatinine, and β2-microglobulin clearance as well as effluent/blood ratios. Data from circuits in CVVHDF-RCA mode are compared with those in standard therapy (CVVHD-RCA) with the same device.
We analyzed ten circuits (5 patients) in CVVHDF-RCA mode and 32 (13 patients) in CVVHD-RCA mode. No adverse events related to the therapy were observed. In CVVHDF-RCA mode, median circuit running time was 68 (IQR 8.1) hours versus 46 (IQR 9.0) in CVVHD mode, p = 0.053. Therapy adaptations (dialysate rate and/or blood flow) were required in one (10%) circuit (15.6% in CVVHD mode, p = 0.56). Compared to CVVHD, CVVHDF was able to achieve similar clearance and effluent/blood ratio for urea, creatinine, and β2-microglobulin across the entire duration of circuit lifetime.
The proposed protocol for CVVHDF-RCA for Omni® was associated with similar circuit lifetime, number of required adaptations and clearances to standard CVVHD-RCA. It appears to be safe and feasible.
Keywords
Blood purification, Citrate, Hemodiafiltration, Renal replacement therapy, Urea clearance
Pubmed
Web of science
Open Access
Yes
Create date
07/06/2022 10:36
Last modification date
18/06/2022 6:34
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