{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:17:15Z","timestamp":1787015835381,"version":"build-2736575974"},"reference-count":42,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T00:00:00Z","timestamp":1698364800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The incidence of coagulation of continuous renal replacement therapy circuits remains high. To the best of our knowledge, no scholar has published a protocol to avoid management errors when different types of citrates coexist in the same Intensive Care Unit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To assess the safety and efficacy of the unification of two protocols with different concentrations of citrate solution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Desing<\/jats:title>\n                    <jats:p>A prospective, quasi\u2010experimental study was carried out in the intensive care unit of a tertiary referral hospital (in Barcelona, Spain), over 3\u2009years. Consecutive adult patients requiring continuous renal replacement therapy with citrate were included. The sample was divided into two groups, a control group (concentrated citrate) and an intervention group (diluted citrate). The decision to initiate anticoagulation with diluted (18\u2009mmol\/L) or concentrated (136\u2009mmol\/L) citrate was made based on the machine available and the decision of the doctor responsible for the patient. It was not possible to randomize the sample. Both protocols were matched with a starting citrate dose of 3.5\u2009mmol\/L, and a dialysis solution was used. Post\u2010filter replacement was not used, and the citrate solution was the only fluid administered pre\u2010filter.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The analysis included 59 circuits in the concentrated citrate group and 40 circuits in the diluted citrate group. An increased need for electrolyte replacement was observed in the diluted group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001). The concentrated citrate group had a longer filter life (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.05), and there was a slight trend toward alkalosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The diluted citrate group had a higher incidence of electrolyte replacement. The concentrated citrate group had longer circuit lifespan and a trend toward metabolic alkalosis, although this was not statistically significant. If these conclusions are considered, the protocol can be unified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>The present work aims to provide information on the differences in the use of regional anticoagulation with diluted or concentrated citrate. The objective is to pay special attention to aspects that can lead to complications. The unified protocol proposed in this paper could be extrapolated to any machine on the market that uses either of these two types of citrate concentration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.12991","type":"journal-article","created":{"date-parts":[[2023,10,28]],"date-time":"2023-10-28T02:24:10Z","timestamp":1698459850000},"page":"1005-1014","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Comparison of diluted vs concentrated regional citrate anticoagulation in continuous renal replacement therapy: A quasi\u2010experimental study"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7978-8392","authenticated-orcid":false,"given":"Almudena","family":"Mateos\u2010D\u00e1vila","sequence":"first","affiliation":[{"name":"Department of Fundamental and Medico\u2010Surgical Nursing, Nursing School, Faculty of Medicine and Health Sciences, Campus Cl\u00ednic Universitat de Barcelona  Barcelona Spain"},{"name":"Nursing Care Research Group, Sant Pau Biomedical Research Institute (IIB SANT PAU) Hospital de la Santa Creu i Sant Pau  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9059-4046","authenticated-orcid":false,"given":"Antonio Jorge","family":"Betbes\u00e9 Roig","sequence":"additional","affiliation":[{"name":"Intensive Care Unit Hospital de la Santa Creu i Sant Pau  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0627-6887","authenticated-orcid":false,"given":"Jos\u00e9 Alberto","family":"Santos Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Intensive Care Unit Hospital de la Santa Creu i Sant Pau  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9866-7265","authenticated-orcid":false,"given":"Eva Maria","family":"Guix\u2010Comellas","sequence":"additional","affiliation":[{"name":"Department of Fundamental and Medico\u2010Surgical Nursing, Nursing School, Faculty of Medicine and Health Sciences, Campus Cl\u00ednic Universitat de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,27]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1744-9987.12656"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-024411"},{"issue":"9","key":"e_1_2_15_4_1","article-title":"Single\u2010best choice between intermittent versus continuous renal replacement therapy: a review","volume":"11","author":"Fathima N","year":"2019","journal-title":"Cureus"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00101-019-0587-x"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-020-0648-y"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000505260"},{"issue":"13","key":"e_1_2_15_8_1","first-page":"2084","article-title":"Influence research of extracorporeal circulation nursing with non anticoagulant CRRT on the coagulation index of patients","volume":"32","author":"Hongjing G","year":"2018","journal-title":"Chin Nurs Res"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/sdi.12946"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aucc.2006.11.001"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1036-7314(06)80026-3"},{"issue":"202","key":"e_1_2_15_12_1","first-page":"1","article-title":"Clinical review: anticoagulation for continuous renal replacement therapy\u2014heparin or citrate?","volume":"15","author":"Straaten H","year":"2011","journal-title":"Crit Care"},{"key":"e_1_2_15_13_1","unstructured":"Lifeder. (14 de noviembre de 2019). Citrato de sodio (C6H5O7Na3): estructura usos propiedades. Recuperado de:https:\/\/www.lifeder.com\/citrato-de-sodio-c6h5o7na3-estructura-usos-obtencion-propiedades\/"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.enfi.2022.07.004"},{"key":"e_1_2_15_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-014-0160-2"},{"key":"e_1_2_15_16_1","doi-asserted-by":"publisher","DOI":"10.1159\/000313765"},{"key":"e_1_2_15_17_1","first-page":"S61","article-title":"Anticoagulation in continuous renal replacement therapy","volume":"154","author":"Rizo\u2010Topete L","year":"2018","journal-title":"Gac Med Mex"},{"key":"e_1_2_15_18_1","doi-asserted-by":"publisher","DOI":"10.1159\/000334641"},{"issue":"2","key":"e_1_2_15_19_1","first-page":"149","article-title":"Risks and benefits of citrate anticoagulation for continuous renal replacement therapy","volume":"21","author":"Shum H","year":"2015","journal-title":"Hong Kong Med J Xianggang Yi Xue Za Zhi"},{"key":"e_1_2_15_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc11645"},{"key":"e_1_2_15_21_1","unstructured":"KellumJ LameireN AspelinP BarsoumR BurdmannE GoldsteinS.Official journal of the International Society of Nephrology KDIGO. 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