Management of regional citrate anticoagulation for continuous renal replacement therapy: guideline recommendations from Chinese emergency medical doctor consensus

Table 10 Additional calories provided by anticoagulation with different citrate solutions

Item	4% TSC solution		ACD-A solution
Item	Postdilution CVVH	CVVHD	Postdilution CVVH	CVVHD
CRRT settings
Blood flow rate (ml/min)	150	100	150	100
Target concentration of citrate (mmol/L)	4	4	4	4
Citrate infusion rate (mmol/h)	36	24	36	24
Replacement fluid/dialysate flow rate (ml/h)	2000	2000	2000	2000
Clearance ratio of CCC (%)	31.75	47.62	31.75	47.62
Energy substrates delivered to patient
Calcium citrate complex (mmol/h)	24.57	12.57	24.57	15.46
Glucose (mmol/h)			30.23	23.20
24 h total calories of RCA (kcal/24 h)	347.91	177.99	877.54	448.85

This table is calculated with a HCT = 30%, plasma flow rate = blood flow rate × (1—HCT), CCC sieving coefficient is 1. The clearance ratio of CCC = dialysis or replacement fluid flow rate/plasma flow rate. TSC trisodium citrate, ACD-A citrate-glucose anticoagulant A, CVVHD continuous veno-venous hemodialysis, CVVH continuous veno-venous hemofiltration, CRRT continuous renal replacement therapy, CCC citrate-calcium complexes, RCA regional citrate anticoagulation, HCT hematocrit

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