Safety and efficacy of citrate anti-coagulation continuous renal replacement therapies in post-cardiac surgery patients with liver dysfunction.

摘要: The study's aim was to examine safety and efficiency of citrate anticoagulated continuous renal replacement therapies (CRRT) in cardiac surgery patients with acute kidney injury associated liver dysfunction. study conducted on critical ICU patients, hospitalized after surgery, who developed failures due low-flow syndrome. CRRT veno-venous hemodiafiltration regional anticoagulation (RCA) prescribed address failure avoid bleeding-risk. Patient Ca(++) measured monitor RCA safety, while thromboelastography (TEG) circuit were used verify efficacy. effectiveness evaluated through creatinine urea levels, function monitored bilirubin, aspartate aminotransferase, glutamic oxaloacetic transaminase (AST GOT) gamma glutamyl transferase (GT) levels. did not require ethical approval. Hepatic confirmed by baseline levels (total bilirubin=3.1 ± 3.37 mg/dL, AST GOT=153 ± 147 U/L GT=93.3 86 IU/L, creatinine=1.97 0.88 blood nitrogen [BUN] 98.13 71.34) assessed 15 patients. During treatment, (patient circuit) remained stable within range for the whole therapy thanks low dose (2.8 0.3 mmol/L blood), hepatic markers show any significant changes therapy, although treatment is contraindicated failure. quality TEG values, which showed an no effects These results involved a high filter lifespan (49.76 22.10 h) effective BUN clearance. No episodes intoxication reported (total/ionized calcium ratio physiologic). during dilute solutions proved both safe, even