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Articles

Albumin-corrected tCa/iCa ratio: are we still diagnosing citrate accumulation or predicting mortality?

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By Hospices Civils de Lyon, Berlin-Mitte Berlin, Hôpital Pasteur
| link.springer.com
Regional citrate anticoagulation (RCA) is recommended as the first-line anticoagulation strategy during continuous renal replacement therapy (CRRT). During RCA-CRRT, citrate accumulation (CA) describes a pathophysiologic process in which systemic citrate delivery exceeds the patient’s metabolic capacity, resulting in a decrease in systemic ionized calcium, and metabolic derangements, including metabolic acidosis [1].
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The “citrate challenge”: mitigating the risk of citrate accumulation in high-risk patients - Critical Care

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By CarMeN Laboratory, Berlin-Mitte Berlin
| link.springer.com
Regional citrate anticoagulation (RCA) is the preferred anticoagulation strategy for continuous renal replacement therapy (CRRT), as it is associated with prolonged hemofilter lifespan and a lower risk of bleeding complications. Citrate exerts its anticoagulant effect by chelating ionized calcium (iCa), forming calcium-citrate complexes (CCC), thereby reducing iCa levels in the extracorporeal circuit.
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