Application of Sodium Bicarbonate Prereduction in Regional Citrate Anticoagulation for Continuous Veno-Venous Hemofiltration.

INTRODUCTION

This study aimed to explore the effectiveness of sodium bicarbonate prereduction during continuous veno-venous hemofiltration (CVVH) with regional citrate anticoagulation (RCA).

METHODS

Patients undergoing CVVH with RCA were randomly divided into a control group and a prereduction group, with the latter receiving reduced sodium bicarbonate concentration levels to achieve the desired level after 3 h of treatment. The investigation focused on variations in pH, bicarbonate ion levels, and the frequency of sodium bicarbonate dosage adjustments at different intervals during CVVH.

RESULTS

The 41 participants (20 in the control group, 21 in the prereduction group) treated from July 2023 to February 2024 had no statistically significant differences in demographic or clinical characteristics. The prereduction group demonstrated significantly lower bicarbonate ion levels in the 4th hour (23.62 ± 2.66 mmol/L) compared with the control group (26.57 ± 2.17 mmol/L, p < 0.05) and required fewer bicarbonate adjustments (0 [0,1] times vs. 2 [1,3] times in the control group, p < 0.05).

CONCLUSION

Sodium bicarbonate prereduction during CVVH using RCA minimises bicarbonate ion fluctuations and reduces the need for dosage adjustments.