A. Mateos-Dávila RN, MsN, PhDc , J. Martínez Pérez RN, MsN , M.E. Prieto Arriba RN, MsN , R. Macho López RN , E.M. Guix-Comellas RN, MsN, PhD
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Anticoagulación en circuitos de terapias continuas de reemplazo renal
Continuous renal replacement therapies are used as a means of blood clearance in critically ill patients with acute renal failure. Its effectiveness depends on the permeability of the extracorporeal circuit and filter coagulation is the most frequent cause of treatment interruption. This situation carries a risk of blood loss for the patient.
Sodium heparin is the most widely used anticoagulant in these therapies, but it can increase the risk of bleeding. Regional citrate anticoagulation is a safer method compared to sodium heparin.
Citrate is a substance that works by inactivating ionic calcium that participates in the coagulation cascade. It's infused at the inlet of the circuit and neutralized before reaching the patient with calcium replacement. For this reason, it is considered a regional and non-systemic anticoagulant.
However, this anticoagulation system, despite being indicated as the first option by the KDIGO guidelines (Kidney Disease Improving Outcomes), is not yet widespread due to the complexity of its use. It requires specific training for healthcare personnel, especially nurses, who will be responsible for maintaining the circuit while the therapy lasts.
In this article we want to provide the necessary knowledge about anticoagulation to carry out these procedures safely and effectively.
期刊介绍：
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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