Rizo-Topete L, Juncos LA

Language: Spanish
References: 222
Page: 61-71
PDF size: 493.99 Kb.

ABSTRACT

Continuous renal replacement therapies (CRRT) were developed to overcome shortcomings of intermittent haemodialysis in critically ill patients. When CRRT is truly continuous, it provides very effective volume and metabolic control. However, premature loss of extracorporeal circuit patency during CRRT remains a common obstacle and contributes to inadequate treatment, and increased blood loss, costs in nursing time dedicated to CRRT instead of direct patient care. Early loss of circuit patency is related to numerous factors including (a) patient related factors (e.g. critically ill patients with acute kidney injury develop a pro-coagulant state), (b) therapy-related factors (e.g. blood transfusions), and (c) factors related to the CRRT prescription. Thus, strategies implemented to prolong circuit patency must take all these factors into account, particularly those related to CRRT; that is, to optimize the circuit life of the CRRT circuit, one must implement a comprehensive strategy that includes optimization of the catheter, circuit, and CRRT prescription. While optimization of these factors will improve circuit life, anticoagulation is generally also required to maximize it. This can be accomplished via systemic or regional (intra-circuit) anticoagulation strategies. This paper provides an overview of the most commonly used anticoagulation strategies being used in CRRT.

REFERENCES

1. Connor MJ Jr, Karakala N. Continuous renal replacement therapy: reviewing current best practice to provide high-quality extracorporeal therapy to critically ill patients. Adv Chronic Kidney Dis. 2017;24;213-8.

2. Golper TA. Hybrid renal replacement therapies for critically ill patients. Contrib Nephrol. 2004;144;278-83.

3. Manns B, Doig CJ, Lee H, Dean S, Tonelli M, Johnson D, et al. Cost of acute renal failure requiring dialysis in the intensive care unit: clinical and resource implications of renal recovery. Crit Care Med. 2003; 31;449-55.

4. Pannu N, Gibney RN. Renal replacement therapy in the intensive care unit. Ther Clin Risk Manag. 2005;1;141-50.

5. Rewa OG, Villeneuve PM, Lachance P, Eurich DT, Stelfox HT, Gibney RTN, et al. Quality indicators of continuous renal replacement therapy (CRRT) care in critically ill patients: a systematic review. Intensive Care Med. 2017;43;750-63.

6. Rewa O, Villeneuve PM, Eurich DT, Stelfox HT, Gibney RT, Hartling L, et al. Quality indicators in continuous renal replacement therapy (CRRT) care in critically ill patients: protocol for a systematic review. Syst Rev. 2015;4;102.

7. Baldwin I. Factors affecting circuit patency and filter ‘life’. Contrib Nephrol. 2007;156;178-84.

8. Zhang L, Tanaka A, Zhu G, Baldwin I, Eastwood GM, Bellomo R. Patterns and mechanisms of artificial kidney failure during continuous renal replacement therapy. Blood Purif. 2016;41;254-63.

9. Baldwin I, Bellomo R. Relationship between blood flow, access catheter and circuit failure during CRRT: a practical review. Contrib Nephrol. 2004;144;203-13.

10. Venkataraman R, Kellum JA, Palevsky P. Dosing patterns for continuous renal replacement therapy at a large academic medical center in the United States. J Crit Care. 2002;17;246-50.

11. Davenport A. The coagulation system in the critically ill patient with acute renal failure and the effect of an extracorporeal circuit. Am J Kidney Dis. 1997;30;S20-7.

12. Shulman RI, Singer M, Rock J. Continuous renal replacement therapy. Keeping the circuit open: lessons from the lab. Blood Purif. 2002;20;275-81.

13. Al-Dorzi HM, Al-Heijan A, Tamim HM, Al-Ghamdi G, Arabi YM. Renal failure as a risk factor for venous thromboembolism in critically Ill patients: a cohort study. Thromb Res. 2013;132;671-5.

14. Davenport A. Anticoagulation for acute dialysis. En: Jörres A, Ronco C, Kellum JA, editores. Management of acute kidney problems. Springer- Verlag Berlin Heidelberg; 2010. pp. 559-75.

15. Davenport A. What are the anticoagulation options for intermittent hemodialysis? Nat Rev Nephrol. 2011;7;499.

16. Bellomo R, Ronco C, Mehta RL, Asfar P, Boisrame-Helms J, Darmon M, et al. Acute kidney injury in the ICU: from injury to recovery: reports from the 5th Paris International Conference. Ann Intensive Care. 2017;7;49.

17. Annich GM. Extracorporeal life support: the precarious balance of hemostasis. J Thromb Haemost. 2015;13 Suppl 1;S336-42.

18. Millar JE, Fanning JP, McDonald CI, McAuley DF, Fraser JF. The inflammatory response to extracorporeal membrane oxygenation (ECMO): a review of the pathophysiology. Crit Care. 2016;20;387.

19. Davenport A. Central venous catheters for hemodialysis: How to overcome the problems. Hemodial Int. 2000;4;78-82.

20. Joannidis M, Oudemans-van Straaten HM. Clinical review: Patency of the circuit in continuous renal replacement therapy. Crit Care. 2007;11;218.

21. Davenport A, Tolwani A. Citrate anticoagulation for continuous renal replacement therapy (CRRT) in patients with acute kidney injury admitted to the intensive care unit. NDT Plus. 2009;2;439-47.

22. Tolwani AJ, Prendergast MB, Speer RR, Stofan BS, Wille KM. A practical citrate anticoagulation continuous venovenous hemodiafiltration protocol for metabolic control and high solute clearance. Clin J Am Soc Nephrol. 2006;1;79-87.

23. Sahota S, Rodby R. Inpatient hemodialysis without anticoagulation in adults. Clin Kidney J. 2014;7;552-6.

24. Nongnuch A, Tangsujaritvijit V, Davenport A. Anticoagulation for renal replacement therapy for patients with acute kidney injury. Minerva Urol Nefrol. 2016;68;87-104.

25. González de Molina FJ, Galindo M, González C, Broch MJ, Del Bano L, Roglan A. Vascular access and extracorporeal circuit patency in continuous renal replacement therapy. Med Intensiva. 2016;40;572-85.

26. Bellomo R, Teede H, Boyce N. Anticoagulant regimens in acute continuous hemodiafiltration: a comparative study. Intensive Care Med. 1993; 19;329-32.

27. Dungen HD, von Heymann C, Ronco C, Kox WJ, Spies CD. Renal replacement therapy: physical properties of hollow fibers influence efficiency. Int J Artif Organs. 2001;24;357-66.

28. Kumar VA, Yeun JY, Depner TA, Don BR. Extended daily dialysis vs. continuous hemodialysis for ICU patients with acute renal failure: a twoyear single center report. Int J Artif Organs. 2004;27;371-9.

29. Honore P, Wittebole X, Lozano A. Evaluation of the predilution technique in reducing the occurrence of bleeding during continuous venovenous haemofiltration in critically ill patients. Efficacy of predilution in reducing the amount of anticoagulation during CVVH. Critical Care 1997;1;P071.

30. Kaplan AA. Predilution versus postdilution for continuous arteriovenous hemofiltration. Trans Am Soc Artif Intern Organs. 1985;31;28-32.

31. Uchino S, Fealy N, Baldwin I, Morimatsu H, Bellomo R. Pre-dilution vs. post-dilution during continuous veno-venous hemofiltration: impact on filter life and azotemic control. Nephron Clin Pract. 2003;94;c94-8.

32. van der Voort PH, Gerritsen RT, Kuiper MA, Egbers PH, Kingma WP, Boerma EC. Filter run time in CVVH: pre- versus post-dilution and nadroparin versus regional heparin-protamine anticoagulation. Blood Purif. 2005;23;175-80.

33. Nagarik AP, Soni SS, Adikey GK, Raman A. Comparative study of anticoagulation versus saline flushes in continuous renal replacement therapy. Saudi J Kidney Dis Transpl. 2010;21;478-83.

34. Panphanpho S, Naowapanich S, Ratanarat R. Use of saline flush to prevent filter clotting in continuous renal replacement therapy without anticoagulant. J Med Assoc Thai. 2011;94 Suppl 1;S105-10.

35. Ramesh Prasad GV, Palevsky PM, Burr R, Lesko JM, Gupta B, Greenberg A. Factors affecting system clotting in continuous renal replacement therapy: results of a randomized, controlled trial. Clin Nephrol. 2000;53; 55-60.

36. Chanard J, Lavaud S, Randoux C, Rieu P. New insights in dialysis membrane biocompatibility: relevance of adsorption properties and heparin binding. Nephrol Dial Transplant. 2002;18;252-7.

37. Oudemans-van Straaten HM, Kellum JA, Bellomo R. Clinical review: anticoagulation for continuous renal replacement therapy--heparin or citrate? Crit Care. 2011;15;202.

38. van de Wetering J, Westendorp RG, van der Hoeven JG, Stolk B, Feuth JD, Chang PC. Heparin use in continuous renal replacement procedures: the struggle between filter coagulation and patient hemorrhage. J Am Soc Nephrol. 1996;7;145-50.

39. Bhattarai M, Rajapakase R, Palevsky PM. Continuous renal replacement therapies (CRRT) Overview. En: Magee CC, Tucker JK, Singh AK. editores. Core concepts in dialysis and continuous therapies. Springer US; 2016. pp. 191-203.

40. de Pont AC, Oudemans-van Straaten HM, Roozendaal KJ, Zandstra DF. Nadroparin versus dalteparin anticoagulation in high-volume, continuous venovenous hemofiltration: a double-blind, randomized, crossover study. Crit Care Med. 2000;28;421-5.

41. Joannidis M, Kountchev J, Rauchenzauner M, Schusterschitz N, Ulmer H, Mayr A, et al. Enoxaparin vs. unfractionated heparin for anticoagulation during continuous veno-venous hemofiltration: a randomized controlled crossover study. Intensive Care Med. 2007;33;1571-9.

42. Wynckel A, Bernieh B, Toupance O, N’Guyen PH, Wong T, Lavaud S, et al. Guidelines to the use of enoxaparin in slow continuous hemodialysis. Contrib Nephrol. 1991;93;221-4.

43. Jeffrey RF, Khan AA, Douglas JT, Will EJ, Davison AM. Anticoagulation with low molecular weight heparin (Fragmin) during continuous hemodialysis in the intensive care unit. Artif Organs. 1993;17;717-20.

44. Reeves JH, Cumming AR, Gallagher L, O’Brien JL, Santamaria JD. A controlled trial of low-molecular-weight heparin (dalteparin) versus unfractionated heparin as anticoagulant during continuous venovenous hemodialysis with filtration. Crit Care Med. 1999;27;2224-8.

45. Voiculescu M IG, Ionescu C. Anticoagulation efficacy and safety with a low molecular weight heparin-tinzaparin in continous renal replacecment therapies. Blood Purif. 2002;20.

46. Sakariassen KS, Ottenhof-Rovers M, Sixma JJ. Factor VIII-von Willebrand factor requires calcium for facilitation of platelet adherence. Blood. 1984;63;996-103.

47. Flanigan MJ, Pillsbury L, Sadewasser G, Lim VS. Regional hemodialysis anticoagulation: hypertonic tri-sodium citrate or anticoagulant citrate dextrose- A. Am J Kidney Dis. 1996;27;519-24.

48. Pinnick RV, Wiegmann TB, Diederich DA. Regional citrate anticoagulation for hemodialysis in the patient at high risk for bleeding. N Engl J Med. 1983;308;258-61.

49. Bos JC, Grooteman MP, van Houte AJ, Schoorl M, van Limbeek J, Nubé MJ. Low polymorphonuclear cell degranulation during citrate anticoagulation: a comparison between citrate and heparin dialysis. Nephrol Dial Transplant. 1997;12;1387-93.

50. Dhondt A, Vanholder R, Tielemans C, Glorieux G, Waterloos MA, De Smet R, et al. Effect of regional citrate anticoagulation on leukopenia, complement activation, and expression of leukocyte surface molecules during hemodialysis with unmodified cellulose membranes. Nephron. 2000;85;334-42.

51. Berridge MJ, Bootman MD, Roderick HL. Calcium signalling: dynamics, homeostasis and remodelling. Nat Rev Mol Cell Biol. 2003;4;517-29.

52. Oudemans-van Straaten HM, Ostermann M. Bench-to-bedside review: Citrate for continuous renal replacement therapy, from science to practice. Crit Care. 2012;16;249.

53. Martin TJ, Kang Y, Robertson KM, Virji MA, Marquez JM. Ionization and hemodynamic effects of calcium chloride and calcium gluconate in the absence of hepatic function. Anesthesiology. 1990;73;62-5.

54. Lake C, Beecroft CL. Extravasation injuries and accidental intra-arterial injection. Continuing Education in Anaesthesia Critical Care & Pain. 2010;10;109-13.

55. Oudemans-van Straaten HM. Citrate anticoagulation for continuous renal replacement therapy in the critically ill. Blood Purif. 2010;29;191-6.

56. Fealy N, Baldwin I, Johnstone M, Egi M, Bellomo R. A pilot randomized controlled crossover study comparing regional heparinization to regional citrate anticoagulation for continuous venovenous hemofiltration. Int J Artif Organs. 2007;30;301-7.

57. Betjes MG, van Oosterom D, van Agteren M, van de Wetering J. Regional citrate versus heparin anticoagulation during venovenous hemofiltration in patients at low risk for bleeding: similar hemofilter survival but significantly less bleeding. J Nephrol. 2007;20;602-8.

58. Stucker F, Ponte B, Tataw J, Martin P-Y, Wozniak H, Pugin J, et al. Efficacy and safety of citrate-based anticoagulation compared to heparin in patients with acute kidney injury requiring continuous renal replacement therapy: a randomized controlled trial. Critical Care. 2015; 19;91.

59. Hetzel GR, Schmitz M, Wissing H, Ries W, Schott G, Heering PJ, et al. Regional citrate versus systemic heparin for anticoagulation in critically ill patients on continuous venovenous haemofiltration: a prospective randomized multicentre trial. Nephrol Dial Transplant. 2011; 26;232-9.

60. Kutsogiannis DJ, Gibney RT, Stollery D, Gao J. Regional citrate versus systemic heparin anticoagulation for continuous renal replacement in critically ill patients. Kidney Int. 2005;67;2361-7.

61. Monchi M, Berghmans D, Ledoux D, Canivet JL, Dubois B, Damas P. Citrate vs. heparin for anticoagulation in continuous venovenous hemofiltration: a prospective randomized study. Intensive Care Med. 2004;30;260-5.

62. Group KDIGOKAKIW. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney inter, Supp 2012;2;124-138.

63. Brain M, Anderson M, Parkes S, Fowler P. Magnesium flux during continuous venovenous haemodiafiltration with heparin and citrate anticoagulation. Crit Care Resusc. 2012;14(4):274-82.

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75. Connor MJ Jr, Karakala N. Continuous renal replacement therapy: reviewing current best practice to provide high-quality extracorporeal therapy to critically ill patients. Adv Chronic Kidney Dis. 2017;24;213-8.

76. Golper TA. Hybrid renal replacement therapies for critically ill patients. Contrib Nephrol. 2004;144;278-83.

77. Manns B, Doig CJ, Lee H, Dean S, Tonelli M, Johnson D, et al. Cost of acute renal failure requiring dialysis in the intensive care unit: clinical and resource implications of renal recovery. Crit Care Med. 2003; 31;449-55.

78. Pannu N, Gibney RN. Renal replacement therapy in the intensive care unit. Ther Clin Risk Manag. 2005;1;141-50.

79. Rewa OG, Villeneuve PM, Lachance P, Eurich DT, Stelfox HT, Gibney RTN, et al. Quality indicators of continuous renal replacement therapy (CRRT) care in critically ill patients: a systematic review. Intensive Care Med. 2017;43;750-63.

80. Rewa O, Villeneuve PM, Eurich DT, Stelfox HT, Gibney RT, Hartling L, et al. Quality indicators in continuous renal replacement therapy (CRRT) care in critically ill patients: protocol for a systematic review. Syst Rev. 2015;4;102.

81. Baldwin I. Factors affecting circuit patency and filter ‘life’. Contrib Nephrol. 2007;156;178-84.

82. Zhang L, Tanaka A, Zhu G, Baldwin I, Eastwood GM, Bellomo R. Patterns and mechanisms of artificial kidney failure during continuous renal replacement therapy. Blood Purif. 2016;41;254-63.

83. Baldwin I, Bellomo R. Relationship between blood flow, access catheter and circuit failure during CRRT: a practical review. Contrib Nephrol. 2004;144;203-13.

84. Venkataraman R, Kellum JA, Palevsky P. Dosing patterns for continuous renal replacement therapy at a large academic medical center in the United States. J Crit Care. 2002;17;246-50.

85. Davenport A. The coagulation system in the critically ill patient with acute renal failure and the effect of an extracorporeal circuit. Am J Kidney Dis. 1997;30;S20-7.

86. Shulman RI, Singer M, Rock J. Continuous renal replacement therapy. Keeping the circuit open: lessons from the lab. Blood Purif. 2002;20;275-81.

87. Al-Dorzi HM, Al-Heijan A, Tamim HM, Al-Ghamdi G, Arabi YM. Renal failure as a risk factor for venous thromboembolism in critically Ill patients: a cohort study. Thromb Res. 2013;132;671-5.

88. Davenport A. Anticoagulation for acute dialysis. En: Jörres A, Ronco C, Kellum JA, editores. Management of acute kidney problems. Springer- Verlag Berlin Heidelberg; 2010. pp. 559-75.

89. Davenport A. What are the anticoagulation options for intermittent hemodialysis? Nat Rev Nephrol. 2011;7;499.

90. Bellomo R, Ronco C, Mehta RL, Asfar P, Boisrame-Helms J, Darmon M, et al. Acute kidney injury in the ICU: from injury to recovery: reports from the 5th Paris International Conference. Ann Intensive Care. 2017;7;49.

91. Annich GM. Extracorporeal life support: the precarious balance of hemostasis. J Thromb Haemost. 2015;13 Suppl 1;S336-42.

92. Millar JE, Fanning JP, McDonald CI, McAuley DF, Fraser JF. The inflammatory response to extracorporeal membrane oxygenation (ECMO): a review of the pathophysiology. Crit Care. 2016;20;387.

93. Davenport A. Central venous catheters for hemodialysis: How to overcome the problems. Hemodial Int. 2000;4;78-82.

94. Joannidis M, Oudemans-van Straaten HM. Clinical review: Patency of the circuit in continuous renal replacement therapy. Crit Care. 2007;11;218.

95. Davenport A, Tolwani A. Citrate anticoagulation for continuous renal replacement therapy (CRRT) in patients with acute kidney injury admitted to the intensive care unit. NDT Plus. 2009;2;439-47.

96. Tolwani AJ, Prendergast MB, Speer RR, Stofan BS, Wille KM. A practical citrate anticoagulation continuous venovenous hemodiafiltration protocol for metabolic control and high solute clearance. Clin J Am Soc Nephrol. 2006;1;79-87.

97. Sahota S, Rodby R. Inpatient hemodialysis without anticoagulation in adults. Clin Kidney J. 2014;7;552-6.

98. Nongnuch A, Tangsujaritvijit V, Davenport A. Anticoagulation for renal replacement therapy for patients with acute kidney injury. Minerva Urol Nefrol. 2016;68;87-104.

99. González de Molina FJ, Galindo M, González C, Broch MJ, Del Bano L, Roglan A. Vascular access and extracorporeal circuit patency in continuous renal replacement therapy. Med Intensiva. 2016;40;572-85.

100. Bellomo R, Teede H, Boyce N. Anticoagulant regimens in acute continuous hemodiafiltration: a comparative study. Intensive Care Med. 1993; 19;329-32.

101. Dungen HD, von Heymann C, Ronco C, Kox WJ, Spies CD. Renal replacement therapy: physical properties of hollow fibers influence efficiency. Int J Artif Organs. 2001;24;357-66.

102. Kumar VA, Yeun JY, Depner TA, Don BR. Extended daily dialysis vs. continuous hemodialysis for ICU patients with acute renal failure: a twoyear single center report. Int J Artif Organs. 2004;27;371-9.

103. Honore P, Wittebole X, Lozano A. Evaluation of the predilution technique in reducing the occurrence of bleeding during continuous venovenous haemofiltration in critically ill patients. Efficacy of predilution in reducing the amount of anticoagulation during CVVH. Critical Care 1997;1;P071.

104. Kaplan AA. Predilution versus postdilution for continuous arteriovenous hemofiltration. Trans Am Soc Artif Intern Organs. 1985;31;28-32.

105. Uchino S, Fealy N, Baldwin I, Morimatsu H, Bellomo R. Pre-dilution vs. post-dilution during continuous veno-venous hemofiltration: impact on filter life and azotemic control. Nephron Clin Pract. 2003;94;c94-8.

106. van der Voort PH, Gerritsen RT, Kuiper MA, Egbers PH, Kingma WP, Boerma EC. Filter run time in CVVH: pre- versus post-dilution and nadroparin versus regional heparin-protamine anticoagulation. Blood Purif. 2005;23;175-80.

107. Nagarik AP, Soni SS, Adikey GK, Raman A. Comparative study of anticoagulation versus saline flushes in continuous renal replacement therapy. Saudi J Kidney Dis Transpl. 2010;21;478-83.

108. Panphanpho S, Naowapanich S, Ratanarat R. Use of saline flush to prevent filter clotting in continuous renal replacement therapy without anticoagulant. J Med Assoc Thai. 2011;94 Suppl 1;S105-10.

109. Ramesh Prasad GV, Palevsky PM, Burr R, Lesko JM, Gupta B, Greenberg A. Factors affecting system clotting in continuous renal replacement therapy: results of a randomized, controlled trial. Clin Nephrol. 2000;53; 55-60.

110. Chanard J, Lavaud S, Randoux C, Rieu P. New insights in dialysis membrane biocompatibility: relevance of adsorption properties and heparin binding. Nephrol Dial Transplant. 2002;18;252-7.

111. Oudemans-van Straaten HM, Kellum JA, Bellomo R. Clinical review: anticoagulation for continuous renal replacement therapy--heparin or citrate? Crit Care. 2011;15;202.

112. van de Wetering J, Westendorp RG, van der Hoeven JG, Stolk B, Feuth JD, Chang PC. Heparin use in continuous renal replacement procedures: the struggle between filter coagulation and patient hemorrhage. J Am Soc Nephrol. 1996;7;145-50.

113. Bhattarai M, Rajapakase R, Palevsky PM. Continuous renal replacement therapies (CRRT) Overview. En: Magee CC, Tucker JK, Singh AK. editores. Core concepts in dialysis and continuous therapies. Springer US; 2016. pp. 191-203.

114. de Pont AC, Oudemans-van Straaten HM, Roozendaal KJ, Zandstra DF. Nadroparin versus dalteparin anticoagulation in high-volume, continuous venovenous hemofiltration: a double-blind, randomized, crossover study. Crit Care Med. 2000;28;421-5.

115. Joannidis M, Kountchev J, Rauchenzauner M, Schusterschitz N, Ulmer H, Mayr A, et al. Enoxaparin vs. unfractionated heparin for anticoagulation during continuous veno-venous hemofiltration: a randomized controlled crossover study. Intensive Care Med. 2007;33;1571-9.

116. Wynckel A, Bernieh B, Toupance O, N’Guyen PH, Wong T, Lavaud S, et al. Guidelines to the use of enoxaparin in slow continuous hemodialysis. Contrib Nephrol. 1991;93;221-4.

117. Jeffrey RF, Khan AA, Douglas JT, Will EJ, Davison AM. Anticoagulation with low molecular weight heparin (Fragmin) during continuous hemodialysis in the intensive care unit. Artif Organs. 1993;17;717-20.

118. Reeves JH, Cumming AR, Gallagher L, O’Brien JL, Santamaria JD. A controlled trial of low-molecular-weight heparin (dalteparin) versus unfractionated heparin as anticoagulant during continuous venovenous hemodialysis with filtration. Crit Care Med. 1999;27;2224-8.

119. Voiculescu M IG, Ionescu C. Anticoagulation efficacy and safety with a low molecular weight heparin-tinzaparin in continous renal replacecment therapies. Blood Purif. 2002;20.

120. Sakariassen KS, Ottenhof-Rovers M, Sixma JJ. Factor VIII-von Willebrand factor requires calcium for facilitation of platelet adherence. Blood. 1984;63;996-103.

121. Flanigan MJ, Pillsbury L, Sadewasser G, Lim VS. Regional hemodialysis anticoagulation: hypertonic tri-sodium citrate or anticoagulant citrate dextrose- A. Am J Kidney Dis. 1996;27;519-24.

122. Pinnick RV, Wiegmann TB, Diederich DA. Regional citrate anticoagulation for hemodialysis in the patient at high risk for bleeding. N Engl J Med. 1983;308;258-61.

123. Bos JC, Grooteman MP, van Houte AJ, Schoorl M, van Limbeek J, Nubé MJ. Low polymorphonuclear cell degranulation during citrate anticoagulation: a comparison between citrate and heparin dialysis. Nephrol Dial Transplant. 1997;12;1387-93.

124. Dhondt A, Vanholder R, Tielemans C, Glorieux G, Waterloos MA, De Smet R, et al. Effect of regional citrate anticoagulation on leukopenia, complement activation, and expression of leukocyte surface molecules during hemodialysis with unmodified cellulose membranes. Nephron. 2000;85;334-42.

125. Berridge MJ, Bootman MD, Roderick HL. Calcium signalling: dynamics, homeostasis and remodelling. Nat Rev Mol Cell Biol. 2003;4;517-29.

126. Oudemans-van Straaten HM, Ostermann M. Bench-to-bedside review: Citrate for continuous renal replacement therapy, from science to practice. Crit Care. 2012;16;249.

127. Martin TJ, Kang Y, Robertson KM, Virji MA, Marquez JM. Ionization and hemodynamic effects of calcium chloride and calcium gluconate in the absence of hepatic function. Anesthesiology. 1990;73;62-5.

128. Lake C, Beecroft CL. Extravasation injuries and accidental intra-arterial injection. Continuing Education in Anaesthesia Critical Care & Pain. 2010;10;109-13.

129. Oudemans-van Straaten HM. Citrate anticoagulation for continuous renal replacement therapy in the critically ill. Blood Purif. 2010;29;191-6.

130. Fealy N, Baldwin I, Johnstone M, Egi M, Bellomo R. A pilot randomized controlled crossover study comparing regional heparinization to regional citrate anticoagulation for continuous venovenous hemofiltration. Int J Artif Organs. 2007;30;301-7.

131. Betjes MG, van Oosterom D, van Agteren M, van de Wetering J. Regional citrate versus heparin anticoagulation during venovenous hemofiltration in patients at low risk for bleeding: similar hemofilter survival but significantly less bleeding. J Nephrol. 2007;20;602-8.

132. Stucker F, Ponte B, Tataw J, Martin P-Y, Wozniak H, Pugin J, et al. Efficacy and safety of citrate-based anticoagulation compared to heparin in patients with acute kidney injury requiring continuous renal replacement therapy: a randomized controlled trial. Critical Care. 2015; 19;91.

133. Hetzel GR, Schmitz M, Wissing H, Ries W, Schott G, Heering PJ, et al. Regional citrate versus systemic heparin for anticoagulation in critically ill patients on continuous venovenous haemofiltration: a prospective randomized multicentre trial. Nephrol Dial Transplant. 2011; 26;232-9.

134. Kutsogiannis DJ, Gibney RT, Stollery D, Gao J. Regional citrate versus systemic heparin anticoagulation for continuous renal replacement in critically ill patients. Kidney Int. 2005;67;2361-7.

135. Monchi M, Berghmans D, Ledoux D, Canivet JL, Dubois B, Damas P. Citrate vs. heparin for anticoagulation in continuous venovenous hemofiltration: a prospective randomized study. Intensive Care Med. 2004;30;260-5.

136. Group KDIGOKAKIW. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney inter, Supp 2012;2;124-138.

137. Brain M, Anderson M, Parkes S, Fowler P. Magnesium flux during continuous venovenous haemodiafiltration with heparin and citrate anticoagulation. Crit Care Resusc. 2012;14(4):274-82.

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214. Kozek-Langenecker SA, Kettner SC, Oismueller C, Gonano C, Speiser W, Zimpfer M. Anticoagulation with prostaglandin E1 and unfractionated heparin during continuous venovenous hemofiltration. Crit Care Med. 1998;26;1208-12.

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216. Ryan KE, Lane DA, Flynn A, Ireland H, Boisclair M, Shepperd J, et al. Antithrombotic properties of dermatan sulphate (MF 701) in haemodialysis for chronic renal failure. Thromb Haemost. 1992;68;563-9.

217. Lindhoff-Last E, Betz C, Bauersachs R. Use of a low-molecular-weight heparinoid (danaparoid sodium) for continuous renal replacement therapy in intensive care patients. Clin Appl Thromb Hemost. 2001;7; 300-4.

218. de Pont AC, Hofstra JJ, Pik DR, Meijers JC, Schultz MJ. Pharmacokinetics and pharmacodynamics of danaparoid during continuous venovenous hemofiltration: a pilot study. Crit Care. 2007;11;R102.

219. Treschan TA, Schaefer MS, Geib J, Bahlmann A, Brezina T, Werner P, et al. Argatroban versus Lepirudin in critically ill patients (ALicia): a randomized controlled trial. Crit Care. 2014;18;588.

220. Bijsterveld NR, Moons AH, Boekholdt SM, van Aken BE, Fennema H, Peters RJ, et al. Ability of recombinant factor VIIa to reverse the anticoagulant effect of the pentasaccharide fondaparinux in healthy volunteers. Circulation. 2002;106;2550-4.

221. Lisman T, Bijsterveld NR, Adelmeijer J, Meijers JC, Levi M, Nieuwenhuis HK, et al. Recombinant factor VIIa reverses the in vitro and ex vivo anticoagulant and profibrinolytic effects of fondaparinux. J Thromb Haemost. 2003;1;2368-73.

222. Young G, Yonekawa KE, Nakagawa PA, Blain RC, Lovejoy AE, Nugent DJ. Recombinant activated factor VII effectively reverses the anticoagulant effects of heparin, enoxaparin, fondaparinux, argatroban, and bivalirudin ex vivo as measured using thromboelastography. Blood Coagul Fibrinolysis. 2007;18;547-53.