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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8.	易金燕, 黃善三, 何小萍, 等. 血液透析管采血檢測血糖的可行性研究. 護理研究, 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, Buturovi?-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.	劉成, 鄒琪. 正-反向連接血液透析導管對首次連續性腎臟替代治療急性腎損傷患者影響的初步探討. 臨床內科雜志, 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.	劉俊雅, 劉偉權, 熊杰, 等. 4%枸櫞酸抗凝 CRRT 不同采血點游離鈣濃度的對比. 湖北科技學院學報(醫學版), 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. 王俊紅, 黃麗璇. 行連續性血液凈化 ICU 患者不同采血方法的血糖值差異. 東南國防醫藥, 2017, 19(1): 94-95.
3. 代明金, 周丹, 張雪梅, 等. i-STAT便攜式血氣分析儀在連續性腎臟替代治療中的應用. 華西醫學, 2013, 28(2): 263-264.
4. 陳香美. 血液凈化標準操作規程(2010 版). 北京: 人民軍醫出版社, 2010: 47, 68-69.
5. 潘夏蓁, 方希敏, 方瑤, 等. 連續靜脈靜脈血液濾過治療中管路采血對血生化的影響. 護理與康復, 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. 陳志文, 唐曉娟, 王蓓蓓, 等. 微量泵補鉀與傳統補鉀在連續性腎臟替代治療中的應用效果比較. 華西醫學, 2018, 33(7): 856-859.
8. 易金燕, 黃善三, 何小萍, 等. 血液透析管采血檢測血糖的可行性研究. 護理研究, 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, Buturovi?-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. 劉成, 鄒琪. 正-反向連接血液透析導管對首次連續性腎臟替代治療急性腎損傷患者影響的初步探討. 臨床內科雜志, 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. 劉俊雅, 劉偉權, 熊杰, 等. 4%枸櫞酸抗凝 CRRT 不同采血點游離鈣濃度的對比. 湖北科技學院學報(醫學版), 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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