CRRT dialysis circuit using regional citrate anticoagulation with the Gambro Prisma machine. CRRT dialysis circuit using regional citrate anticoagulation.

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Presentation transcript:

CRRT dialysis circuit using regional citrate anticoagulation with the Gambro Prisma machine. CRRT dialysis circuit using regional citrate anticoagulation with the Gambro Prisma machine. The 4% trisodium citrate (TSC) mean infusion rate was 180 ml/h and Qb was 100 ml/min. TSC was added at the arterial catheter port and ionized calcium levels were sampled postfilter. Citrate flow rates were subsequently adjusted based on postfilter ionized calcium values to be maintained within a range of 0.25 to 0.4 mmol/L. The prefilter BUN value was measured after the infusion of TSC and predilution fluid (Qr), thereby accounting for the predilutional effect of these solutions. The technique for fluid balance used a fixed ultrafiltration rate (1000 ml/h) to achieve a target effluent volume; substitution fluid (Qs) was varied hourly to achieve a negative, zero, or positive fluid balance. Qb, blood flow rate; Qd, dialysate flow rate; Qr, replacement fluid rate; Quf, total ultrafiltration rate; Qnet, net fluid removal rate. Rolando Claure-Del Granado et al. CJASN 2011;6:467-475 ©2011 by American Society of Nephrology