Table 8 Summary of the benefits and limitations of citrate anticoagulation
Benefits | Limitations | Monitoring |
|---|---|---|
Compared to heparin Safety ↑ Tolerance ↑ Risk of bleeding ↓ Circuit life ↑ Delivered CRRT dose ↑ Biocompatibility ↑ Cheaper | Accumulation in case of persistent hypoperfusion and decreased mitochondrial capacity Difficult to understand Strict protocol is needed Adherence to the protocol is required | Systemic iCa and acid base balance 6–8 hourly Total calcium and total/iCa ratio once daily or more frequently if the risk of accumulation is high |