A retrospective review on the use of Regional citrate Anticoagulation (RCA) in Continuous Venovenous Hemofiltration (CVVH) for critically ill patients

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Use of citrate as regional anticoagulant had been demonstrated to associate with longer filter-life, less bleeding events and improved mortality. It is superior to unfractionated heparin in prolonging filter lifetime and the anticoagulant effect is limited within the circuit without systemic disturbances. However, the complex set up and training required had limited the widespread use of citrate. In recent years, the availability of this commercial prepared pre-mixed citrate solution had greatly simplified its use and had been published in various studies as well as a local case series. The proprietary diluted citrate solution available in Hong Kong is the Prismocitrate 10/2, Gambro, which contains 10 mmol/L of trisodium citrate and 2mmol/L of citric acid. Based on these clinical studies, our unit had modified our regional citrate CVVH regime since July 2010 and demonstrated satisfactory result. We would like to conduct a retrospective study to evaluate its effect on circuit patency, rate of correction of the patient’s metabolic disorder and any untoward electrolyte imbalance after applying this regime in a heterogeneous group of critically ill patients

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