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Open Access

Bicarbonate buffered dialysate and replacement solutions for CRRT: effect of crystallization on the measured levels of electrolytes and buffer

  • E Maccariello1,
  • E Rocha1,
  • M Aparecida Dalboni1,
  • A Teixeira Ferreira1,
  • S Draibe1 and
  • M Cendoroglo1
Critical Care20015(Suppl 3):P37

https://doi.org/10.1186/cc1370

Published: 26 June 2001

Keywords

CalciumPotassiumNegative CorrelationBicarbonateEmergency Medicine

The aim of this study was to investigate the impact of the addition of calcium to bicarbonate solutions for CRRT. We tested single bag (SB; bicarbonate and calcium mixed 24 h before testing) and double bag (DB) solutions (mixed immediately before), with and without the addition of 4 mEq/l acetate. Prescribed calcium varied from 0-5 mEq/l. In all test solutions prepared with calcium 5 mEq/l there was a decrease in the measured calcium concentration. SB solutions presented lower concentrations of calcium, compared with DB solutions. When the prescribed calcium concentration was increased, there was a parallel increase in calcium deficit (prescribed-measured). The prescribed calcium showed a negative correlation with sodium and potassium and a positive correlation with pCO2. We also found a positive correlation between calcium deficit and pCO2 (r = +0.59; P < 0.001). The crystallization, as measured by the weight of the crystals, was greater in the SB solutions when compared to the DB solutions (17.7 ± 7.0 mg versus 9.1 ± 1.8 mg, n = 14; P = 0.01). The crystallization correlated with the measured concentration of calcium (r = -0.62; P = 0.02), and pCO2 (r = +0.75; P = 0.002). We also observed a negative correlation between the pH, and the pCO2 (r = -0.82; P < 0.001). Our results suggest that the use of bicarbonate solutions containing calcium as replacement fluids for CRRT is a potentially unsafe procedure.

Authors’ Affiliations

(1)
Divison of Nephrology, Department of Biophysics, University Federal de São Paulo, São Paulo; Division of Nephrology, University Federal Fluminense, Rio de Janeiro, Brazil

Copyright

© The Author(s) 2001

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