Clinical study on blood sampling test of arteriovenous reversal in continuous renal replacement therapy_West China Medical Journal

Authors：

DAI Mingjin ¹ ,  ZHANG Ling ² , WANG Fang ¹ , CHEN Zhiwen ¹ , WEI Tiantian ² , FAN Xia ¹

1. Department of Nephrology, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Nephrology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

ZHANG Ling, Email: zhanglinglzy@163.com

Keywords：

Continuous renal replacement therapy; Reverse arteriovenous connection; Venous blood collection; Blood sample examination

DOI：

10.7507/1002-0179.201907041

Video：

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Objective To explore the feasibility of pipeline blood sampling test of continuous renal replacement therapy (CRRT) when arteriovenous reversal connection occurs, and to explore the influence of pipeline blood sampling test on the results of CRRT when arteriovenous reversal connection occurs under different anticoagulation methods.Methods Selected patients with arteriovenous reversals treated by CRRT in a third-class A hospital was selected from June 2018 to May 2019. Blood samples were collected from the front end of the CRRT pipeline (0-, 3-, and 5-min after the cease). Blood samples collected from the catheterization site were compared with those from the body vein for acid and alkali, respectively. The electrolyte and other results were analyzed and compared.Results A total of 80 patients were enrolled, including 40 with low molecular weight heparin and non-heparin, and 40 with citric acid. Under the anticoagulation condition of low molecular weight heparin and non-heparin, there was no difference in acid-base or electrolyte between body venous blood samples and pipeline blood samples (P>0.05). Under the anticoagulation condition of citric acid, 0-, 3-, and 5-min after the cease, the difference in free calcium between body venous blood samples and pipeline blood samples was significant (F=7.866, 6.691, 5.590, P<0.001). There was no difference in other acid-base or electrolyte results (P>0.05).Conclusions Low molecular weight heparin and heparin-free anticoagulation can be tested by collecting blood samples from the front end of the pipeline without suspension of treatment in the case of arteriovenous reversal in CRRT. There was a difference between free calcium and body venous blood in anticoagulation with citric acid. It is not recommended to collect blood from pipes for examination Under the anticoagulationcondition of citric acid.

Citation： DAI Mingjin, ZHANG Ling, WANG Fang, CHEN Zhiwen, WEI Tiantian, FAN Xia. Clinical study on blood sampling test of arteriovenous reversal in continuous renal replacement therapy. West China Medical Journal, 2020, 35(7): 804-808. doi: 10.7507/1002-0179.201907041 Copy

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2.	王俊红, 黄丽璇. 行连续性血液净化 ICU 患者不同采血方法的血糖值差异. 东南国防医药, 2017, 19(1): 94-95.
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6.	Atapour A, Mosakazemi M, Mortazavi M, et al. Access recirulation in jugular venous catheter in regular and reversed lines. Iran J Kidney Dis, 2008, 2(2): 91-94.
7.	陈志文, 唐晓娟, 王蓓蓓, 等. 微量泵补钾与传统补钾在连续性肾脏替代治疗中的应用效果比较. 华西医学, 2018, 33(7): 856-859.
8.	易金燕, 黄善三, 何小萍, 等. 血液透析管采血检测血糖的可行性研究. 护理研究, 2017, 31(20): 2547-2549.
9.	Moossavi S, Vachharajani TJ, Jordan J, et al. Retrospective analysis of catheter recirculation in prevalent dialysis patients. Semin Dial, 2008, 21(3): 289-292.
10.	Sefer S, Kes P, Degoricija V, et al. Recirculation of urea and dialysis efficiency using dual-lumen dialysis catheters in various location: may the venous lumen of the catheter be used as the arterial lumen and vice versa?. Lijec Vjesn, 2003, 125(1/2): 1-5.
11.	Kovac J, Buturović-Ponikvar J, Ponikvar R. Vascular access recirculation in hemodialysis patients with two noncuffed, single-lumen, jugular catheters in the same jugular vein. Ther Apher Dial, 2009, 13(4): 350-353.
12.	Little MA, Conlon PJ, Walshe JJ. Access recirculation in temporary hemodialysis catheters as measured by the saline dilution technique. Am J kidney Dis, 2000, 36(6): 1135-1139.
13.	刘成, 邹琪. 正-反向连接血液透析导管对首次连续性肾脏替代治疗急性肾损伤患者影响的初步探讨. 临床内科杂志, 2017, 34(4): 236-238.
14.	Kidney Disease: Improving Global Outcomes (KDIGO). KDIGO clinical practice guideline for acute kidney injury. Kidney Inter, 2012, 2(Suppl 1): 1-138.
15.	刘俊雅, 刘伟权, 熊杰, 等. 4%枸橼酸抗凝 CRRT 不同采血点游离钙浓度的对比. 湖北科技学院学报(医学版), 2008, 32(6): 517-519.

1. Aldawood A. Outcome and prognostic factors of critically ill patients with acute renal failure requiring continuous renal replacement therapy. Saudi J Kidney Dis Transpl, 2010, 21(6): 1106-1110.
2. 王俊红, 黄丽璇. 行连续性血液净化 ICU 患者不同采血方法的血糖值差异. 东南国防医药, 2017, 19(1): 94-95.
3. 代明金, 周丹, 张雪梅, 等. i-STAT便携式血气分析仪在连续性肾脏替代治疗中的应用. 华西医学, 2013, 28(2): 263-264.
4. 陈香美. 血液净化标准操作规程(2010 版). 北京: 人民军医出版社, 2010: 47, 68-69.
5. 潘夏蓁, 方希敏, 方瑶, 等. 连续静脉静脉血液滤过治疗中管路采血对血生化的影响. 护理与康复, 2014, 13(7): 627-628, 632.
6. Atapour A, Mosakazemi M, Mortazavi M, et al. Access recirulation in jugular venous catheter in regular and reversed lines. Iran J Kidney Dis, 2008, 2(2): 91-94.
7. 陈志文, 唐晓娟, 王蓓蓓, 等. 微量泵补钾与传统补钾在连续性肾脏替代治疗中的应用效果比较. 华西医学, 2018, 33(7): 856-859.
8. 易金燕, 黄善三, 何小萍, 等. 血液透析管采血检测血糖的可行性研究. 护理研究, 2017, 31(20): 2547-2549.
9. Moossavi S, Vachharajani TJ, Jordan J, et al. Retrospective analysis of catheter recirculation in prevalent dialysis patients. Semin Dial, 2008, 21(3): 289-292.
10. Sefer S, Kes P, Degoricija V, et al. Recirculation of urea and dialysis efficiency using dual-lumen dialysis catheters in various location: may the venous lumen of the catheter be used as the arterial lumen and vice versa?. Lijec Vjesn, 2003, 125(1/2): 1-5.
11. Kovac J, Buturović-Ponikvar J, Ponikvar R. Vascular access recirculation in hemodialysis patients with two noncuffed, single-lumen, jugular catheters in the same jugular vein. Ther Apher Dial, 2009, 13(4): 350-353.
12. Little MA, Conlon PJ, Walshe JJ. Access recirculation in temporary hemodialysis catheters as measured by the saline dilution technique. Am J kidney Dis, 2000, 36(6): 1135-1139.
13. 刘成, 邹琪. 正-反向连接血液透析导管对首次连续性肾脏替代治疗急性肾损伤患者影响的初步探讨. 临床内科杂志, 2017, 34(4): 236-238.
14. Kidney Disease: Improving Global Outcomes (KDIGO). KDIGO clinical practice guideline for acute kidney injury. Kidney Inter, 2012, 2(Suppl 1): 1-138.
15. 刘俊雅, 刘伟权, 熊杰, 等. 4%枸橼酸抗凝 CRRT 不同采血点游离钙浓度的对比. 湖北科技学院学报(医学版), 2008, 32(6): 517-519.

West China Medical Journal

Clinical study on blood sampling test of arteriovenous reversal in continuous renal replacement therapy

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