Evidence map›Paper›PMID 40632271›Full record

ArticleEuropean journal of pediatrics2025

Evaluation of anticoagulant methods in newborns undergoing continuous renal replacement therapy: what is the optimum method?

Dogan Kaymaz, Selin Aslan Bayhan, Yasemin Ezgi Kostekci, Ferhan Demirtas, Aysen Durak Aslan, Merve Havan, Emel Okulu, Omer Erdeve, Fatma Begum Atasay, Tanıl Kendirli and 1 more

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in European journal of pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

11 authors.

Dogan KaymazDivision of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye. dogankaymaz5@gmail.com.
Selin Aslan BayhanDepartment of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye.
Yasemin Ezgi KostekciDivision of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye.
Ferhan DemirtasDivision of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye.
Aysen Durak AslanDivision of Pediatric Intensive Care, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye.
Merve HavanDivision of Pediatric Intensive Care, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye.
Emel OkuluDivision of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye.
Omer ErdeveDivision of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye.
Fatma Begum AtasayDivision of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye.
Tanıl KendirliDivision of Pediatric Intensive Care, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye.
Saadet ArsanDivision of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Türkiye.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Implementing continuous renal replacement therapy (CRRT) in neonates is technically challenging due to complexities with vascular access, the risk of hemodynamic instability, and the need for precise anticoagulation management. Regional citrate anticoagulation has been shown to manage bleeding risks more effectively than heparin; however, its use in neonates is controversial due to potential adverse effects. This study aimed to evaluate the association between anticoagulation methods and the incidence of complications in neonates undergoing CRRT. We conducted a retrospective analysis of neonates who underwent CRRT from July 2014 to July 2024. Pre-dialysis characteristics were evaluated in infants receiving regional citrate or heparin anticoagulation. Dialysis duration, filter lifespan, and dialysis-related complications were compared between the two anticoagulation regimens. A total of 27 patients who received CRRT were included in the study. There were no significant differences between the two groups regarding gestational age, birth weight, dialysis initiation day, dialysis indications, pre-dialysis organ failure, or dialysis methods employed (p > 0.05). Dialysis-related bleeding, blood product requirements, thermoregulatory disturbances, infections, inotrope requirements, electrolyte imbalances, and metabolic disturbances during dialysis were comparable between the two groups (p > 0.05). A total of 36 dialysis sessions were conducted over 653 h, with a longer filter lifespan in the regional citrate group compared to the heparin group [18 h (10-19 h) vs. 8 h (3-24 h), p = 0.02]. The mortality rates were comparable (p = 0.13).

conclusionThe use of regional citrate as an anticoagulant in neonatal CRRT is a safe and effective alternative to heparin. It prolongs filter lifespan without increasing dialysis-related complications. WHAT IS KNOWN: • Continuous renal replacement therapy (CRRT) has gained popularity in recent years; however, the need for anticoagulation presents a significant challenge in neonatal CRRT. • Regional citrate anticoagulation (RCA) has been shown to be more effective and safer than heparin, in adult and pediatric patients. Data on the comparative safety and efficacy of citrate versus heparin in neonates remain limited. WHAT IS NEW: • RCA is a safe and effective alternative to systemic heparin anticoagulation in neonates undergoing CRRT. • RCA demonstrated a significant advantage in prolonging filter lifespan without increasing the risk of bleeding, metabolic complications, or mortality in neonatal CRRT.

Indexed as

AnticoagulantsCitric AcidContinuous Renal Replacement TherapyHeparinFemaleHemorrhageHumansInfant, NewbornMaleRetrospective StudiesAnticoagulantsCitric AcidHeparinCitrateComplicationsContinuous renal replacement therapyHeparinNeonatal intensive care unit

Identifiers

PMID40632271

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.