Safety and efficacy of citrate anticoagulation for septic patients with liver patients

Abstract

Objective To evaluate the efficacy and safety of citrate anticoagulation for continuous renal placement therapy (CRRT) in septic patients with liver dysfunction. Methods The data of septic patients who needed to CRRT and were admitted into the department of critical care medicine from January 2016 to December 2017 were enrolled in this study. Liver dysfunction was defined as Child-Turotte-Pugh (CTP) score >4. A total of fifty-six patients met the criteria. According to the patient′s actual condition, they were divided into citrate groups (29 cases) and low molecular weight heparin (LMWH) group (29 cases). Patients in LMWH group were given slow molecular weight heparin. The efficacy and safety were compared between the two groups. The filter lifetime, after treatment the activated partial thromboplastin time (APTT),hemoglobin (Hb) were compared between the two groups. Results The average filter lifetime in citrate group was (25.0±12.2) h which was longer than (13.7±4.5) h in LMWH group (t=13.17, P<0.01). The average service life of each filter was (4.2±1.9) h which was lower than (8.7±3.6) in LMWH group (t=8.395, P<0.05). Conclusions Regional Citrate anticoagulation is a safe and effective option for CRRT in septic patients with liver dysfunction, without causing electrolyte disturbance and internal environment. Key words: Citrate anticoagulation; Liver dysfunction; Septic