Evidence map›Paper›PMID 14600809›Full record

Trial reportIntensive care medicine2004

Citrate vs. heparin for anticoagulation in continuous venovenous hemofiltration: a prospective randomized study.

Mehran Monchi, Denis Berghmans, Didier Ledoux, Jean-Luc Canivet, Bernard Dubois, Pierre Damas

Registry-linked trialAbstract readClinical TrialComparative StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Intensive care medicine, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03976440 (Simplified Regional Citrate Anticoagulation Protocols for CVVH, CVVHDF and SLED Focused on the Prevention of RRT-related Hypophosphatemia and Optimization of Acid-base Balance), which is not on this map. Cited by 102 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
102citing papers in PubMed, 12 pooled it
9.3field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03976440 unknown statusnot on this mapstarted 2019, after this paper: background citation

Simplified Regional Citrate Anticoagulation Protocols for CVVH, CVVHDF and SLED Focused on the Prevention of RRT-related Hypophosphatemia and Optimization of Acid-base Balance: a Pilot Study

TypeobservationalSponsorUniversity of ParmaRan2019 to 2021Enrolled30ConditionsAcute Renal Failure, Dialysis Related Complication, Hypophosphatemia, HypomagnesemiaArmsRenal Replacement Therapy (RRT) start
3 · Its place in the literature

Who cites it

102 citing papers in PubMed, 12 syntheses or guidelines pooled it, 372 citations in OpenAlex.

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42 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Mehran MonchiGeneral Intensive Care and Department of Nephrology, University Hospital, 4000, Liege, Belgium. m.monchi@free.fr.
Denis BerghmansGeneral Intensive Care and Department of Nephrology, University Hospital, 4000, Liege, Belgium.
Didier LedouxGeneral Intensive Care and Department of Nephrology, University Hospital, 4000, Liege, Belgium.
Jean-Luc CanivetGeneral Intensive Care and Department of Nephrology, University Hospital, 4000, Liege, Belgium.
Bernard DuboisGeneral Intensive Care and Department of Nephrology, University Hospital, 4000, Liege, Belgium.
Pierre DamasGeneral Intensive Care and Department of Nephrology, University Hospital, 4000, Liege, Belgium.
University of Liège · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare the efficacy and safety of adjusted-dose unfractionated heparin with that of regional citrate anticoagulation in intensive care patients treated by continuous venovenous hemofiltration (CVVH). DESIGN AND

settingProspective, randomized, clinical trial in a 32-bed medical and surgical ICU in a university teaching hospital. PATIENTS: ICU patients with acute renal failure requiring continuous renal replacement therapy, without cirrhosis, severe coagulopathy, or known sensitivity to heparin.

interventionsBefore the first CVVH run patients were randomized to receive anticoagulation with heparin or trisodium citrate. Patients eligible for another CVVH run received the other study medication in a cross-over fashion until the fourth circuit. MEASUREMENTS AND

resultsForty-nine circuits (hemofilters) were analyzed: 23 with heparin and 26 with citrate. The median lifetime of hemofilters was 70 h (interquartile range 44-140) with citrate anticoagulation and 40 h (17-48) with heparin (p=0.0007). One major bleeding occurred during heparin anticoagulation and one metabolic alkalosis (pH=7.60) was noted with citrate after a protocol violation. Transfusion rates (units of red cells per day of CVVH) were, respectively, 0.2 (0.0-0.4) with citrate and 1.0 (0.0-2.0) with heparin (p=0.0008).

conclusionsRegional citrate anticoagulation seems superior to heparin for the filter lifetime and transfusion requirements in ICU patients treated by continuous renal replacement therapy.

Indexed as

HemofiltrationAcute Kidney InjuryAdultAnticoagulantsCitric AcidCreatinineCritical CareFemaleHeparinHumansMaleMiddle AgedProspective StudiesTreatment OutcomeUreaAnticoagulantsCitric AcidCreatinineHeparinUrea

Identifiers

PMID14600809
OpenAlexW1970935602

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.