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  • Title: Semiautomated Regional Citrate Anticoagulation for Continuous Kidney Replacement Therapy: An Observational Study in Young Children.
    Author: Liet JM, Baleine J, Demaret P, Mounier S, Porcheret F, Joram N, Chenouard A.
    Journal: Pediatr Crit Care Med; 2022 Sep 01; 23(9):e429-e433. PubMed ID: 35583226.
    Abstract:
    OBJECTIVES: To review use of semiautomated regional citrate anticoagulation (saRCA) for continuous kidney replacement therapy (CKRT) in young children. DESIGN: Retrospective cohort study. SETTING: Three independent PICUs. PATIENTS: All consecutive children weighing less than 11 kg who received CKRT with saRCA from January 2015 to June 2020. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Twenty-one children weighing less than 11 kg underwent CKRT with saRCA. The total duration of the CKRT was 2,014 hours, with a total of 64 CKRT sessions. Citrate intoxication occurred in four of 64 CKRT sessions (6%). Citrate intoxication was consistently observed in the few CKRT sessions where the initial lactate concentration was greater than 4 mmol/L or the ratio of replacement fluid flow to citrate flow less than 50%. The rate of unscheduled interruptions of CKRT sessions was 25% (16/64). CONCLUSIONS: We have used saRCA for CKRT in children weighing less than 11 kg. A strict protocol and intensive training are required to minimize complications.
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