Continuous Renal Replacement Therapy (CRRT) involves pumping blood through a dialysis circuit. When the blood comes in contact with this surface it tends to clot which is why we anticoagulate blood that is being dialysed. CRRT involves and extended period of treatment at slower blood pump rates and is therefore more likely to clot.

Citrate has quickly become the gold standard for anticoagulation due to the limited adverse events and a decrease in cost compared to the use of heparin.

Citrate works by binding to ionised calcium therefore rendering it unable to perform in the clotting cascade.

GCUH will be rolling out citrate for CRRT in November, so we had a chat to the driving force behind this Lisa Gray (Nursing educator) and Matt Ostwald (ICU Consultant).