Effects of two different regional citrate anticoagulation CVVH protocols on acid-base status and phosphate supplementation

Regional citrate anticoagulation (RCA) is increasingly used in high bleeding risk patients undergoing CRRT. Regardless of anticoagulation protocol, hypophosphatemia occurs frequently in CRRT. The aim was to evaluate the effects on electrolyte and acid-base status of a new RCA-CVVH protocol using an 18 mmol/l citrate solution combined with a phosphate-containing replacement fluid, compared with a previously adopted RCA-CVVH protocol combining a 12 mmol/l citrate solution with a conventional replacement fluid.