The Application Of Regional Citrate Anticoagulation In Continuous Blood Purification In Patients With Mods

Objective:To discuss the influence of local citrate anticogulation (RCA) in continuous blood purification (CBP) during the treatment of MODS patients on blood coagulation function and its treatment effect. Methods:From January 2009 to October 2010,35 patients in CBP with MODS from our hospital were divided into two groups:group of local citrate anticogulation (RCA), and No heparin group. The correlation between MODS and coagulation parameters; changes in MODS, coagulation parameters, blood gas and biochemical indicators before and after treatment were analyzed. The coagulation during cardiopulmonary bypass, life of filter and the clinical bleed events were observed. Results: 1) CBP treatment methods of Both groups were uncorrelated to coagulation parameters (P >0.05).2) During CBP treatments the PBE,PV,TMP at0,2,4,6,8,10,12hours were not interclassly differences (P<0.05), the PA were interclassly differences (P>0.05); the PA,PBE,PV were group differences (P<0.05), the TMP were not group differences (P>0.05).3) The comparatives in life of filter and number of replacement:Group A 29.84±21.34 hours, group B 11.46±17.13 hours, this results were significantly different (P <0.05); 5.9% patients' filter were replaced in group A within 24 hours,88.9% in group B respectively (P<0.05).4) After receiving CBP treatment, creatinine,carbamide,MODS grade were significantly decreased in two groups (P<0.05), especially creatinine was significantly decreased in group A (P<0.05).5) After the treatment of local citrate anticogulation (RCA) in continuous blood purification (CBP), iCa,sodium,HCO3 level were not statistically different (P>0.05). PH level was increased in group A (P<0.05).6) There were no after treatment complication in two groups.7) There was correlation in MODS grate and coagulation parameters (P<0.05). Conclusion:The local citrate anticogulation (RCA) in continuous blood purification (CBP) during the treatment of MODS patients proves safe and effective and no-influence in coagulation parameters, it increases life of filter with no complication.