CVVHD with regional citrate anticoagulation
Core principle, typical target values, and workflow outline — as a starting point for your center-specific protocol.
Principle
Citrate is infused pre-dilutionally into the extracorporeal circuit and chelates ionized calcium, inhibiting the coagulation cascade within the filter. Calcium is separately replaced systemically to maintain physiological calcium levels in the patient.
Typical target values
| Parameter | Target range | Monitoring interval |
|---|---|---|
| Ionized Ca²⁺ in the filter circuit | 0.25–0.35 mmol/l | every 4–6 h |
| Systemic ionized Ca²⁺ | 1.0–1.2 mmol/l | every 6–12 h |
| Total-to-ionized Ca ratio | < 2.5 | if citrate accumulation is suspected |
Example values for orientation — exact target ranges and monitoring intervals should follow your local SOP.
This is a placeholder protocol to illustrate the page structure. Before launch, this should be replaced with a complete, literature-referenced protocol including a version number and date.