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首页> 外文期刊>Artificial Organs >Effectiveness and Safety Assessment of Citrate Anticoagulation During Albumin Dialysis in Comparison to Other Methods of Anticoagulation
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Effectiveness and Safety Assessment of Citrate Anticoagulation During Albumin Dialysis in Comparison to Other Methods of Anticoagulation

机译：抗白蛋白透析期间柠檬酸酸抗凝的有效性及安全评估与其他抗凝方法相比

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Liver failure is a serious and often deadly disease often requiring MARS (Molecular Adsorbent Recirculating System) therapy. Choosing the safe and effective method of anticoagulation during artificial liver support systems seems to be very difficult and extremely important. The aim of this study was to assess effectiveness and safety of regional anticoagulation with citrate in liver failure patients during MARS. We used a single center observational study. We analyzed 158 MARS sessions performed in 65 patients: 105 (66.5%) sessions in 41 patients with heparin anticoagulation, 40 (25.3%) sessions in 19 patients with citrate, and 13 (8%) sessions in only five patients without anticoagulation, that were excluded from part of the analysis. To determine the effectiveness of regional anticoagulation with citrate, probability of filter survival and changes in laboratory parameters were analyzed according to the applied method of anticoagulation. The safety of citrate was determined by Ca/Ca2+ ratio, acid-base balance, bleeding complications, and the need for blood product transfusions. The probability of filter survival in the citrate group was 94% and in the heparin group 82% (P=0.204). There was no relationship between the method of anticoagulation and effectiveness of MARS therapy in lowering the levels of the analyzed parameters. Only one patient had a Ca/Ca2+ ratio higher than he safety margin. There were no statistically significant changes in pH and lactate level irrespective of anticoagulation; bicarbonate dropped significantly only in the heparin group (P=0.03). The frequency of bleeding complications and the need for transfusions did not differ significantly between groups. Regional anticoagulation with citrate can be an effective and safe method of anticoagulation during MARS therapy, but requires attentive monitoring and further studies in liver failure patients.
机译：肝功能衰竭是一种严重且经常致命的疾病，通常需要火星（分子吸附剂再循环系统）治疗。在人工肝脏支持系统中选择安全有效的抗凝方法似乎是非常困难和极其重要的。本研究的目的是评估在火星期间肝脏衰竭患者柠檬酸盐的区域抗凝的有效性和安全性。我们使用单一中心观察研究。我们分析了65名患者的158名火星会话：41例肝素抗凝患者中的105名（66.5％），19例柠檬酸盐的40例（25.3％），13名（8％）次，只有5名没有抗癌的患者，即被排除在分析的一部分中。为了确定区域抗凝血的有效性，根据抗凝的应用方法，分析过滤物存活率和实验室参数变化的可能性。柠檬酸盐的安全性通过Ca / Ca2 +比率，酸碱平衡，出血并发症确定，并且需要血液产物输血。柠檬酸盐组过滤存活的概率为94％，肝素基团82％（P = 0.204）。在降低分析参数水平时，抗凝与抗凝和有效性之间没有关系。只有一个患者的CA / CA2 +比率高于HE安全保证金。无论抗凝如何，pH和乳酸水平都没有统计学上显着的变化;碳酸氢盐只在肝素组中显着下降（P = 0.03）。出血并发症的频率和转输环的需要在组之间没有显着差异。柠檬酸盐的区域抗凝可以是火星疗法期间抗凝的有效和安全的抗凝方法，但需要注意的监测和进一步研究肝功能衰竭患者。

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