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  • Področno preprečevanje strjevanja krvi s citratom med hemodializo : primerjava dializne raztopine z in brez kalcija : (magistrska naloga)
    Černe, Senka
    Effective anticoagulation with unfractionated heparin or low molecular heparinduring hemodialysis procedure is important for efficient and successfuldialysis. However, if heparin is contraindicated ... (risk of bleeding, HIT-heparin-induced thrombocytopenia), regional curate anticoagulation provides safe prevention of blood clotting in dialysis circuit without causingsystemic anticoagulation. In a prospective randomized clinical study wehave compared the efficacy and safety of two protocols for regional anticogulation with trisodium citrate using calcium free dialysate and dialysate with calcium 1,25 mmol/l. In our study we enrolled patients older than 18 years with end stage renal disease, in whom we have already performed regional citrate anticoagulation with 4% solution of trisodium citrate withoutany complications. 50 hemodialysis procedures were randomly assigned (25 to each group) to calcium-free dialysate or calcium containing dialysate (1,25 mmol/l) both with Mg 0,5 mmol/l, lowered concentrations of sodium (138 mmol/l) and bicarbonate (28 mmol/l). We performed regional anticoagulation with infusion of 15% trisodium citrate and 1M CaCl2. The efficiency of anticoagulation was assessed using hour-glass clotting time, measuring concentration of ionised calcium after citrate infusion in dialysis circuit, measuring the volume of clots in arterial or venous bubble trap and counting the number of clotted capillaries in dialyser. The scoring system for evaluation of anticoagulation in the dialyser and arterial and venous bubble trap was ranged from 1 (complete clotting) to 5 (the best, no clotting). During the treatment we monitored the concentrations of ionized calcium, sodium, pH and bicarbonate. Using calcium free dialysate our results showed very good anticoagulation score for both bubble traps (arterial 4,7 +- 0,5 andvenous 4,8 +- 0,6) and dialyzer (4,5 +- 0,6). (Abstract truncated at 2000 characters)
    Vrsta gradiva - magistrsko delo ; neleposlovje za odrasle
    Založništvo in izdelava - [Ljubljana : S. Černe], 2007
    Jezik - slovenski
    COBISS.SI-ID - 3007764

Knjižnica/institucija Kraj Akronim Za izposojo Druga zaloga
MF, Centralna medicinska knjižnica, Ljubljana Ljubljana CMK na dom 1 izv.
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