Citrate pathophysiology and metabolism. Issue 1 (February 2017)

• Record Type: Journal Article
• Authors: Monchi, Mehran
• Is Part Of: Transfusion and apheresis science. Volume 56:Issue 1(2017)
• Page Start: 28
• Page End: 30
• Publication Date: 2017-02
• Subjects: Citrate -- Anticoagulation -- Extra corporeal circuits -- Toxicity -- Pharmacodynamics; Blood -- Transfusion -- Periodicals; Hemapheresis -- Periodicals; 615.39
• DOI: 10.1016/j.transci.2016.12.013
• Languages: English
• ISSNs: 1473-0502

Abstract

Abstract: By chelating ionized calcium, citrate allows extracorporeal circuit anticoagulation without a bleeding risk for the patient. Citrate anticoagulation is also associated with a reduced activation of leucocytes and platelets. Citrate clearance by citric acid cycle (Krebs cycle) is not modified by renal failure, but is reduced by about 50% in patients with cirrhosis. Toxic effects of citrate result from a decrease in plasma ionized calcium of the patient. The first side effect is a prolongation of the QT interval. Clinical signs of hypocalcemia and hypotension in humans appear below 0.9 mmol/L of plasma ionized calcium.