Quality indicators in prolonged hemodialysis with regional citrate anticoagulation with the genius system: retrospective cohort of critical patients with acute kidney injury

Author:

Vieira Jorge Alberto MenegassoORCID,Reinheimer Isabel Cristina,dos Santos Amanda Corrêa,Halperin Fernando Kowarick,Susin Luiza Aguirre,Staub Lia Portella,Ribeiro Raquel Jaqueline Eder,da Silveira Julia Braga,Fontoura Lucas Friedrich,de Souza Diego Candido,Nunes Karen Patrícia,de Souza Vandrea Carla,da Silva Selistre Luciano,Poli-de-Figueiredo Carlos EduardoORCID

Abstract

Abstract Background Prolonged hemodialysis (HD) is performed from 6 to 12 h and can last up to 24 h. To prevent system clotting some studies suggest that Regional Citrate Anticoagulation (RCA) use reduces bleeding rates relative to systemic heparin. However, there may be difficulties in the patient’s clinical management and completing the prescribed HD with Genius system using RCA. Objective To analyze safety Quality Indicators (IQs) and follow up on prolonged HD with 4% sodium citrate solution in a Genius® hybrid system. Methods This is a retrospective cohort conducted in an intensive care unit. Results 53 random sessions of prolonged HD with 4% sodium citrate solution of critically ill patients with AKI assessed. Evaluated safety indicators were dysnatremia and metabolic alkalosis, observed in 15% and 9.4% of the sessions, respectively. Indicators of effectiveness were system clotting which occurred in 17.3%, and the minimum completion of the prescribed HD time, which was 75.5%. Conclusion The assessment of the indicators showed that the use of RCA with a 4% sodium citrate solution in prolonged HD with the Genius system in critically ill patients with AKI can be performed in a simple, safe, and effective way.

Publisher

Springer Science and Business Media LLC

Subject

Nephrology

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