Regional citrate anticoagulation in cardiac surgery patients at high risk of bleeding: a continuous veno-venous hemofiltration protocol with a low concentration citrate solution

Table 1 Clinical characteristics of the patients at the time of starting CRRT and RCA-CVVH initial parameters.

Number = 33 (24 men, 9 women)
Age (years)	70.8 ± 9.5 (range 46 to 85)
Creatinine (mg/dl)	2.5 ± 0.9
Blood urea nitrogen (mg/dl)	54.3 ± 26.2
Mean arterial pressure (mmHg)	72.5 ± 10.2
Oliguric AKI^a	94%
Mechanical ventilation	100%
Total parenteral or enteral nutrition	100%
Use of vasopressors or inotropes	75.8%
APACHE II score	32.1 ± 4.6
SOFA score	13.9 ± 2.5
MELD score	18.7 ± 4.7
Bilirubin (mg/dl)	1.68 ± 1.98
Cardiovascular surgery:
Coronary artery bypass grafting	33.3%
Coronary artery bypass grafting + valvular surgery	27.3%
Ascending aorta replacement	24.2%
Valvular surgery	15.2%
RCA-CVVH initial parameters ^b
Prescribed dialysis dose, corrected for pre-dilution (ml/kg/hour)	28.1 ± 2.9
Blood flow rate (ml/minute)	135.7 ± 14.6
Pre-dilution citrate solution flow rate (l/hour)	1.69 ± 0.23
Post-dilution bicarbonate solution flow rate (l/hour)	0.77 ± 0.17
Calcium chloride 10% (mmol/hour)	2.38 ± 0.77
Citrate infusion rate (mmol/hour)	20.3 ± 2.8
Estimated citrate load (mmol/hour)	11.5 ± 2

Data are expressed as mean ± SD or percentage. ^aAccording to AKIN criteria (Crit Care 2007; 11:R31). ^bData derived from the first RCA-CVVH session for each patient. AKI, acute kidney injury; AKIN, Acute Kidney Injury Network; APACHE, Acute Physiology and Chronic Health Evaluation; CRRT, continuous renal replacement therapy; MELD, Model for End-Stage Liver Disease; RCA-CVVH, regional citrate anticoagulation-continuous veno-venous hemofiltration; SD, standard deviation; SOFA, Sequential Organ Failure Assessment.

ISSN: 1364-8535