Citrate anticoagulation for pediatric continuous venovenous hemodiafiltration
Bibliographic record
Abstract
Objective: Feasibility and safety evaluation of citrate anticoagulation for hemodiafiltration (CVVHD) procedure in a pediatric critical care unit. Patients and Methods:From 08–2002 to 12–2003, five patients were treated by CVVHD with regional citrate anticoagulation, age range 1.4–16 yrs, body weight 6.7–38 kg. Inclusion criteria: oligoanuria and hypervolemia and/or uremia, hemodynamic instability, and impossibility of peritoneal dialysis. The patient's primary diseases were: liver disease (4/5) and chronic renal disease (1/5). All patients were on mechanical ventilation and on vasopressor support and presented with thrombocytopenia. Hepatic dysfunction was observed in four patients. The CVVHD prescription was: blood flow rate: 2–5 ml/min, dialysate and replacement flow rate: 3000 ml/1.73 m2/h. Citrate regional anticoagulation (4% trisodium citrate) was used according to a previously described protocol (Bunchman et al., Pediatr Nephrol 2002: 17:150–154). The duration of each individual procedure was 9–72 hours, and the total time range of CVVHD was 2 to 19 days. A bicarbonate based solution (Na 140 mEq/L and bicarbonate 35 mEq/L) was prepared in our hospital pharmacy. Prisma system (GAMBRO) and polycrylonitrile M‐60 Pre‐set hemofilter was used in 4/5 patients and M‐10 Pre‐set hemofilter in one patient. Results:The use of M‐10 filter was associated with a higher rates of ACD‐A and calcium infusion (ml/h). Metabolic alkalosis was observed in one patient and hypernatremia in three patients. All patients died of causes other than renal failure (sepsis and multiple organ dysfunction syndrome). No bleeding related to citrate occurred. Conclusion: Citrate anticoagulation proved to be feasible with minor side effects in pediatric ICU patients. The high mortality can be related to the severity of multiple organ failure.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".