RCA for CRRT in Hyperlactatemia Patient With Increased Bleeding Risk
NCT ID: NCT04315623
Last Updated: 2020-03-19
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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UNKNOWN
NA
80 participants
INTERVENTIONAL
2020-03-30
2022-03-03
Brief Summary
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
NONE
Study Groups
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Reginal citrate anticoagulation
Patients accepted regional citrate anticoagulation for CRRT. Blood flow 120-220 ml/h. Sodium citrate (4%) infusion before the filter in order to maintain post-filter ionCa2+ level between 0.25 to 0.35 mmol/L. Calcium gluconate supplementary after the filter to maintain serum ionCa2+ level between 1.0 to 1.2 mmol/L. Adjusting the infusion rate of sodium citrate and blood flow according to pre- and post-filtration ionCa2+. Adjusting the infusion rate of calcium gluconate according to the serum ionCa2+ level.
Regional citrate anticoagulation CRRT
Regional citrate anticoagulation Sodium citrate (4%) infusion before the filter in order to maintain post-filter ionCa2+ level between 0.25 to 0.35 mmol/L. Calcium gluconate supplementary after the filter to maintain serum ionCa2+ level between 1.0 to 1.2 mmol/L.
No-anticoagulation
Patients accepted no-anticoagulation CRRT. Blood flow 200 ml/h. The replacement fluid was infused 50% predilution and 50% post-dilution.
No-anticoagulation CRRT
Patients accepted no-anticoagulation CRRT. Blood flow 200 ml/h. The replacement fluid was infused 50% predilution and 50% post-dilution.
Interventions
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Regional citrate anticoagulation CRRT
Regional citrate anticoagulation Sodium citrate (4%) infusion before the filter in order to maintain post-filter ionCa2+ level between 0.25 to 0.35 mmol/L. Calcium gluconate supplementary after the filter to maintain serum ionCa2+ level between 1.0 to 1.2 mmol/L.
No-anticoagulation CRRT
Patients accepted no-anticoagulation CRRT. Blood flow 200 ml/h. The replacement fluid was infused 50% predilution and 50% post-dilution.
Eligibility Criteria
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Inclusion Criteria
* Hyperlactatemia (Lactic acid or serum lactate level \> 2 mmol/L)
* Required CRRT
* Increased bleeding risk: PLT \< 40 x 109, aPTT \> 60 s, INR \> 1.5, bleeding or active bleeding within 7 days, recent trauma or surgery (especially head trauma and neurosurgery), recent stroke, intracranial venous malformation or aneurysm, retinal hemorrhage, uncontrolled hypertension, and epidural catheter implantation.
Exclusion Criteria
* Receiving systemic anticoagulant treatment (heparin/lmol/warfarin/aspirin, etc.) within 24 hours.
* Critical patients with lactic acid ≥15mmol\\L (with a mortality of 100%) were excluded
* Patients with APTT \> 100S were excluded (retrospective data suggested that this type of patients received CRRT treatment should last for more than 24 hours)
* Patients who are pregnant or during lactation
* Severe liver failure: child-pugh score \>10 (chronic severe liver failure), MELD score \> 30 (acute severe liver failure), total bilirubin \>51 mol/L
* Patients with internal fistula were treated with CRRT
* Unable to cooperate with treatment due to mental problems (such as depression and mental illness)
* CRRT with arteriovenous fistula, or the prescribed treatment time \< 12 hours
16 Years
ALL
No
Sponsors
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Air Force Military Medical University, China
OTHER
Responsible Party
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Shiren sun
Professor
Principal Investigators
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Shiren Sun, MD
Role: PRINCIPAL_INVESTIGATOR
Xijing Hospital
Locations
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Xijing Hospital of Nephrology
Xi'an, Shaanxi, China
Countries
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Central Contacts
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Other Identifiers
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RCA-CRRT-Hyperlactatemia
Identifier Type: -
Identifier Source: org_study_id
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