Efficacy and safety of regional citrate anticoagulation in double plasma molecule adsorb system in patients with liver failure
Objective:To compare the efficacy and safety of regional citrate anticoagulation(RCA)and heparin anticoagulation(HA)in double plasma molecule adsorb system(DPMAS).Methods:One hundred and one pa-tients with liver failure who attended the EICU from January 2021 to July 2023 were included.According to the chronological order of liver failure diagnosis,the enrolled patients were divided into two groups using a random number table:the regional citrate anticoagulation(RCA)group with 37 cases and the heparin anticoagulation(HA)group with 39 cases,and 33 cases were finally included in each group according to the inclusion and exclu-sion criteria.The general data of the two groups,observe the liver function,coagulation function,blood ammonia(NH3),blood gas analysis and complications,compare the total bilirubin(TBIL)and NH3 clearance rate,pro-thrombin time activity(PTA)elevation rate after DPMAS treatment,compare the effective rate of treatment,complication rate,and analyse the 28-day cumulative survival rate of the two groups.Results:There was no sta-tistically significant difference in the treatment efficiency,TB1L,NH3,PTA before and after treatment,and the rate of change of the three before and after treatment between the two groups of patients after DPMAS treatment(P＞0.05).TBIL,NH3 decreased and PTA increased in the two groups after treatment,compared with those be-fore treatment(P＜0.05).Citrate accumulation(serum total calcium/ionize calcium ≥ 2.5)was presented 22 times in the RCA group by the end of treatment,and disappeared 1 day after the end of treatment.The complica-tion rates of bleeding and thrombocytopenia were lower in the RCA group than those in the HA group(P＜0.05).The difference in the rates of the remaining complications was not statistically significant(P＞0.05).There was no statistically significant difference between the two groups in acid-base electrolyte indices and 28-days survival rate after the end of treatment.Conclusion:The effective rate of DPMAS with RCA is similar to that with HA,but the former reduces the incidence of bleeding and thrombocytopenia.
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