Evidence map›Paper›PMID 34382281›Full record

ArticleNursing in critical care2022

Reliability of monitoring acid-base and electrolyte parameters through circuit lines during regional citrate anticoagulation-continuous renal replacement therapy.

Fang Wang, Mingjin Dai, Yuliang Zhao, Yingying Yang, Zhiwen Chen, Li Lin, Xue Tang, Ling Zhang

Open access · hybridAbstract read
In one paragraph

Article in Nursing in critical care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 43% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
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

8 authors at 1 institution in 1 country.

Fang WangDepartment of Nephrology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China.ORCID 0000-0002-4504-0271
Mingjin DaiDepartment of Nephrology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China.
Yuliang ZhaoDeparment of Nephrology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Yingying YangDeparment of Nephrology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Zhiwen ChenDepartment of Nephrology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China.
Li LinDepartment of Nephrology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China.
Xue TangDepartment of Nephrology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China.
Ling ZhangDeparment of Nephrology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Sichuan University · CN

Funding

1 3 5 Project for Disciplines of Excellence-Clinical Research Incubation Project, West China Hospital, Sichuan University 2018HXFH018West China Nursing Discipline Development Special Fund Project, Sichuan University HXHL19066
6 · The paper itself

Abstract

backgroundThe current practice involves blood sampling from the circuit line to measure acid-base and electrolyte parameters during continuous renal replacement therapy (CRRT). However, there is limited evidence supporting its reliability due to the effects of anticoagulant mechanism and access recirculation associated with regional citrate anticoagulation (RCA).

aimTo evaluate the reliability of monitoring acid-base and electrolyte parameters through circuit lines in regular and reversed connections during RCA-CRRT. STUDY

designIn this prospective cohort study, we included critically ill patients receiving RCA-CRRT via a double-lumen catheter. During the second hour after CRRT initiation, we collected blood samples to monitor acid-base and electrolyte parameters and their levels were compared between samples from the circuit lines (at 0, 3, and 5 minutes) and those from the central venous catheter (CVC) line (at 0 minute). During this time, CRRT switched to the replacement state as controls.

resultsWe observed 128 CRRT circuits in 60 adult patients receiving RCA-CRRT. Ninety-eight (76.6%) circuits had regular connections, while 30 (23.4%) had reversed connections. Among regular connections, no differences were observed in any acid-base or electrolyte parameters between samples from the CVC line and those from the circuit line at all time points (P > .05). Among reversed connections, ionized calcium levels were dramatically decreased at all three time points in samples from the circuit line compared with those from the CVC line (0.65 ± 0.12, 0.72 ± 0.11, and 0.78 ± 0.99 vs 0.98 ± 0.07 mmol/L, P < .001), with comparable levels of other acid-base or electrolyte parameters between the sampling patterns (P > .05).

conclusionsAcid-base and electrolyte parameters could be reliably monitored through the circuit line during RCA-CRRT in regular connections. However, in reversed connections, pre-filter ionized calcium concentrations determined through the circuit line were lower than those determined through the CVC line. RELEVANCE TO CLINICAL PRACTICE: We suggest sampling from arterial or CVC lines rather than from the circuit line in a reversed connection during RCA-CRRT.

Indexed as

Citric AcidContinuous Renal Replacement TherapyAdultAnticoagulantsCalciumCitratesElectrolytesHumansProspective StudiesReproducibility of ResultsAnticoagulantsCalciumCitratesCitric AcidElectrolytesaccess recirculationacid-base and electrolytescontinuous renal replacement therapyregular connectionreversed connection

Identifiers

PMID34382281
PMCPMC9540182
OpenAlexW3190311136

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Registered trials

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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.