Effects of citrate on renal pulsatility index and coagulation function in patients with septic shock treated with CRRT
Objective:To explore the effects of citrate on renal pulsatility index and coagulation function in patients with septic shock treated with continuous renal replacement therapy(CRRT).Methods:Ninety patients with septic shock who vis-ited our hospital between January 2020 and December 2022 were selected as subjects and were divided into the control group(n=45)and observation group(n=45)using dynamic randomization.Both groups were treated with CRRT,with a blood flow rate set at 180 ml/min and a dialysate flow rate of 2 000 ml/h.The control group was anticoagulated with heparin sodium injection[4 ml of heparin sodium injection mixed with 250 ml of sodium chloride injection intravenously,followed by 16 ml of heparin sodium injection mixed with 1 000 ml of sodium chloride injection intravenously].The observation group was given sodium citrate anticoagulation[10 ml of 10%calcium gluconate per 1 000 ml of blood transfusion for neutralization intravenously],which was continued in both groups until 1.5 h before the end of CRRT treatment.Renal dynamic parameters[renal pulsatility index(RPI),renal resistance index(RRI)],renal function[blood urea nitrogen(BUN),serum creatinine(Scr)],coagulation function[prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT)]and liver function[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBil)]were compared between the two groups before treatment and after seven days of treatment.The average service life of the filter and the inci-dence rate of adverse reactions were statistically compared after seven days of treatment.Results:There was no statistically significant difference in comparing the indicators between the two groups of patients before treatment(P＞0.05).After seven days of treatment,the levels of renal kinetic parameters(RPI,PPI),renal function indexes(BUN,Scr),and hepatic function indexes(ALT,AST,TBil)of patients in the two groups decreased,and the observation group was significantly lower than the control group in the same period(P＜0.05).Coagulation function(PT,TT,APTT)increased,and the observation group was sig-nificantly higher than the control group in the same period(P＜0.05).The service life of filters in the observation group was significantly higher than the control group,and the incidence of adverse reactions was lower than the control group(P＜0.05).Conclusion:Sodium citrate can not only regulate the patients'renal pulsatility index and coagulation status when treating sep-tic shock patients with CRRT but also protect liver and kidney functions,prolong filter life,and improve treatment safety.
万方数据
维普
