Regional Citrate Anticoagulation for RRT During V-V ECMO

• Status: Recruiting
• Trial end date: 2023-12-31
• Target enrollment: 0
• Participant gender: All

Summary

Anticoagulation is an essential component of all extracorporeal therapies. Currently locoregional citrate anticoagulation is the recommended technique for continuous renal replacement therapy (CRRT).

However, low clearance of citrate restricts its use to blood flow up to 150 mL/min, preventing its use in ECMO.

Renal replacement therapy (RRT) is commonly provided to ECMO patients with AKI. In presence of systemic heparinization for ECMO, additional anticoagulation for the CRRT circuit (i.e. RCA) is usually not employed.

Nevertheless, thrombosis occurs more frequently in the CRRT circuit than the oxygenator because of the slower blood flow.

The aim of this prospective, cross-over study is to assess, in patients undergoing CRRT during veno-venous ECMO (vv-ECMO), the efficacy and safety of adding regional citrate anticoagulation (RCA) for CRRT circuit anticoagulation.

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: University of Milano Bicocca
• Treatments: Calcium heparin; Dialysis Solutions; Heparin

Criteria

Inclusion Criteria:

• Patients admitted in ICU

• V-V ECMO support for acute respiratory failure

• CRRT therapy for acute kidney injury

Exclusion Criteria:

• Pregnancy

• Pre-existing coagulation disorders

• Contraindication to heparin or citrate anticoagulation

• Moribund patients