Comparison Of The Efficacy And Safety Of Citrate And Heparin In CRRT Anticoagulation In Patients With Acute Kidney Injury

Objective:To study the local citrate anticoagulation and whole body heparinization anticoagulation in the intensive care unit sepsis in application of continuous renal replacement therapy in patients with acute kidney injury of the comparison of the efficacy and safety.。Methods: a retrospective analysis of hospital intensive medicine above(ICU) of a total of 56 patients with sepsis AKI merger, divided into systemic anticoagulant heparin group(heparin group), a total of 26 cases, lines of CRRT treatment 65 times; Regional citrate anticoagulation(RCA group) 30 cases, lines of CRRT 86 times. Compare two groups of patients in the service life of the filter, filter use time more than 48 h the number and proportion, the causes for the non-normal off the plane and the proportion, needs a blood transfusion patients cases and blood transfusion unit number, peripheral blood activation part blood coagulation time, activated Partial thromboPlastin time; Monitoring of blood urea nitrogen, creatinine, peripheral blood and ca2 + level after filter, and the platelet count, serum sodium, BE value, the differences between the liver function, etc.Results:RCA an effective set of filter used in the heparin group, use the time more than 48 h filter number increased obviously, abnormal plane caused by filter blood coagulation significantly reduced; Two groups of patients after treatment, serum creatinine, blood urea nitrogen, potassium and lactic acid value were significantly lower, TBIL there was no significant difference; Heparin group, all bleeding events and total number of blood transfusion, RCA group significantly increased; Heparin group of bleeding events verified by TEG is caused by the residual heparin in the body, dose heparin anticoagulation difficult to master, even in patients with routine use of doses may lead to bleeding events or increase.Conclusion:the sodium citrate anticoagulation can significantly prolong the life time of the average filter; Heparin anticoagulation can reduce bleeding complications, compared with less number of blood transfusions and total, can be applied to the risk of higher blood anticoagulation of CRRT critically ill patients.