Une voie simple et sécurisée pour la réalisation de l ... au citrate_ertic_2.pdf · A Set of...
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Une voie simple et Une voie simple et s s é é curis curis é é e pour la r e pour la r é é alisation alisation de l de l ’ ’ anticoagulation anticoagulation r r é é gionale au Citrate gionale au Citrate
Transcript of Une voie simple et sécurisée pour la réalisation de l ... au citrate_ertic_2.pdf · A Set of...
Une voie simple et Une voie simple et sséécuriscuriséée pour la re pour la rééalisationalisation
de lde l’’anticoagulationanticoagulationrréégionale au Citrategionale au Citrate
CiCi--Ca Ca therapytherapy systemsystem
Pompes Citrate et Calcium IntPompes Citrate et Calcium Intéégrgrééeses
•• Infusion Citrate Infusion Citrate asservie au asservie au ddéébit sangbit sang
•• Infusion de CalciumInfusion de Calciumasservie asservie àà ll’é’épurationpurationde calciumde calcium
•• Contrôle de toutes Contrôle de toutes
les pompes par les pompes par un seul systun seul systèème me en cas den cas d’’alarmesalarmes
SafetySafety increasedincreased byby integrationintegrationof of thethe citratecitrate and and calciumcalcium pumpspumps
ControlControl of of thetheCiCi--CaCa pumpspumpsvia via thethe useruser
interfaceinterface of of thethemultiFiltratemultiFiltrate
Calcium pump
Citrate pumpand
Pump Pump rotorrotor
SwitchSwitch forfor automaticautomaticpumplinepumpline handlinghandling
CiCi--CaCa®® ModuleModule
CounterCounter dropsdrops
MultiFiltrateMultiFiltrate CiCi--CaCa®®: Completely : Completely Integrated Citrate AnticoagulationIntegrated Citrate Anticoagulation
•• CiCi--CaCa®® Module as extension for the Module as extension for the multiFiltratemultiFiltrate•• Citrate and calcium pumps controlled by the Citrate and calcium pumps controlled by the
multiFiltrate, infused volumes automatically included in multiFiltrate, infused volumes automatically included in the fluid balancethe fluid balance
•• Safe alarm handlingSafe alarm handling•• Control of the treatment via a single intuitive user Control of the treatment via a single intuitive user
interfaceinterface
•• CiCi--CaCa®® CassetteCassette•• Dedicated disposable for a safe Dedicated disposable for a safe
CiCi--CaCa®® TreatmentTreatment•• PrePre--connected citrate and calcium lines ensure correct connected citrate and calcium lines ensure correct
connection of the extracorporeal circuit to the catheterconnection of the extracorporeal circuit to the catheter
•• CiCi--CaCa®® Dialysate K2Dialysate K2•• Adjusted dialysis fluid with adapted sodium and Adjusted dialysis fluid with adapted sodium and
bicarbonate concentrationsbicarbonate concentrations•• Calcium free for an effective anticoagulationCalcium free for an effective anticoagulation
SSéécuriscuriséé et ergonomiqueet ergonomique
•• Pompes Citrate et Calcium intPompes Citrate et Calcium intéégrgrééeses•• Infusion de Citrate asservie au dInfusion de Citrate asservie au déébit sangbit sang•• Infusion de Calcium asservie au calcium Infusion de Calcium asservie au calcium éépurpuréé•• Contrôle de toutes les pompes par un seul systContrôle de toutes les pompes par un seul systèème me
en cas den cas d’’alarmesalarmes
•• Interface utilisateur adaptInterface utilisateur adaptééee•• Prescription facile du traitement CiPrescription facile du traitement Ci--CaCa®®
•• Aide utilisateur intuitifAide utilisateur intuitif•• Instruction de montage Instruction de montage àà ll’é’écrancran
•• Cassette CiCassette Ci--CaCa®® ddéédidiéée incluant e incluant des caractdes caractééristiques de sristiques de séécuritcuritéé::•• Lignes citrate et calcium PrLignes citrate et calcium Préé--connectconnectééeses•• Lignes guidLignes guidéées sur la cassettees sur la cassette•• Code CouleurCode Couleur
MultiFiltrateMultiFiltrate CiCi--CaCa®® System:System:A Set of Matching ComponentsA Set of Matching Components
CiCi--Ca Dialysate K2Ca Dialysate K2The dialysis fluid for CiThe dialysis fluid for Ci--Ca CVVHDCa CVVHD
•• Sodium and bicarbonate reduced, Sodium and bicarbonate reduced, in order to compensate the in order to compensate the systemic infusion of Nasystemic infusion of Na33CitrateCitrate
•• CalciumCalcium--free, to avoid an unnecessary free, to avoid an unnecessary increase of the citrate requirementincrease of the citrate requirement=> Ca=> Ca--substitution mandatorysubstitution mandatory
•• Packaging in a doublePackaging in a double--chamber bagchamber bag
Na+ 133 mmol/lK+ 2 mmol/lMg++ 0.75 mmol/lCa++ 0 mmol/lHCO3
- 20 mmol/lCl 116.5 mmol/lGlukose 1 g/l
SetSet--up of up of thethe bloodblood and and effluenteffluent lineslinesSetSet--up of up of thethe CiCi--Ca Ca lineslinesCompleteComplete setset--upup
MultiFiltrateMultiFiltrate CiCi--CaCa®® CassetteCassette::ComprehensiveComprehensive SetSet--Up Up InstructionsInstructions
Programmation simple du traitementProgrammation simple du traitement
Dose CitrateDose CitrateAjustement de lAjustement de l’’anti anti
coagulation rcoagulation réégionalegionale
Dose CalciumDose CalciumAjustement du Ajustement du
calcium calcium
DDéébits sang et bits sang et dialysatdialysat
Ajustement de Ajustement de ll’é’équilibre quilibre acideacide--basebase
multiFiltrate CimultiFiltrate Ci--CaCa®® System:System:
•• Regional anticoagulation with citrate has been successfully Regional anticoagulation with citrate has been successfully used in continuous renal replacement therapy for a few years used in continuous renal replacement therapy for a few years now without any serious problems.now without any serious problems.
•• More than 20,000More than 20,000 CiCi--Ca Ca treatments still done today with treatments still done today with
the the multiFiltratemultiFiltrate systemsystem
Adjustment of the Adjustment of the citrate and calcium dosecitrate and calcium dose
Citrate Dose: Citrate Dose: IncreasedIncreased SafetySafetybyby OnOn--Screen SupportScreen Support
Citrate dose [mmol/l]Citrate dose [mmol/l]
0.00.0––1.91.9SettingSetting
notnot possiblepossible
2.02.0––2.92.9UnusuallyUnusually lowlowbutbut possiblepossible
3.03.0––5.05.0Expected Expected
rangerange
5.15.1––6.06.0UnusuallyUnusually highhighbutbut possiblepossible
>6.0>6.0SettingSetting
notnot possiblepossible
Calcium Dose: Calcium Dose: IncreasedIncreased SafetySafetybyby OnOn--Screen SupportScreen Support
00––1.21.2NegativeNegative
calciumcalcium balancebalance
1.31.3––2.12.1ExpectedExpected
rangerange
2.22.2––3.03.0Positive Positive calciumcalcium
balancebalance oror signsign forforcitratecitrate accumulationaccumulation
>3.0>3.0SettingSetting notnot possiblepossible::ConsiderConsider changechange of of
treatmenttreatment modemode
Calcium dose [mmol/l]Calcium dose [mmol/l]
20% 20% changechange of of bloodblood oror dialysatedialysate flowflow
=> => approxapprox. 4 mmol/l . 4 mmol/l changechange
of of thethe acidacid--basebase statusstatus
CiCi--CaCa CVVHD: CVVHD: Effect of blood and Effect of blood and dialysate flow on the aciddialysate flow on the acid--base statusbase status
Constant treatment parameters:Citrate dose 3.7 mmol/l, calcium dose 1.7 mmol/l, net fluid removal 100 ml/hVariability between patients not considered
Fresenius Medical CareInternal calculations
CiCi--CaCa CVVHD: CVVHD: Effect of blood and Effect of blood and dialysate flow on the aciddialysate flow on the acid--base statusbase status
PrescribedPrescribedCVVHD dose: CVVHD dose:
3000 ml/h3000 ml/h
Normal Normal acidacid--basebase
statusstatusaimedaimed--atat
RequiredRequiredbloodblood flowflow::150 ml/min150 ml/min
Constant treatment parameters:Citrate dose 3.7 mmol/l, calcium dose 1.7 mmol/l, net fluid removal 100 ml/hVariability between patients not considered
Fresenius Medical CareInternal calculations
multiFiltrate CimultiFiltrate Ci--CaCa®® System: System: Correction of Metabolic AcidosisCorrection of Metabolic Acidosis
MoreMorebloodbloodflowflow
LessLessdialysatedialysate
flowflow or
multiFiltrate CimultiFiltrate Ci--CaCa®® System: System: Correction of Metabolic AlkalosisCorrection of Metabolic Alkalosis
LessLessbloodbloodflowflow
MoreMoredialysatedialysate
flowflow or
Increasing the Efficacy Increasing the Efficacy of Ciof Ci--CaCa®® CVVHDCVVHD
MoreMorebloodbloodflowflow
MoreMoredialysatedialysate
flowflow and
En En pratiquepratique
••Normal rangesNormal ranges•• pH:pH: 7.357.35 –– 7.457.45•• Base excess:Base excess: --2.02.0 –– +2.0 +2.0 mmol/lmmol/l•• Systemic Systemic ionisedionised Ca: Ca: 1.12 1.12 –– 1.20 1.20 mmol/lmmol/l•• Systemic total Ca: Systemic total Ca: 2.2 2.2 –– 2.5 2.5 mmol/lmmol/l
•• Instructions for the dosing adaptationInstructions for the dosing adaptation
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
5-Nov 15:00 100 2000 4.0 1.7 100
Systemic total Ca
Base excess
Date Time pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
5-Nov 15:00 100 2000 4.0 1.7 100
5-Nov 15:05 0.38
Systemic total Ca
Base excess
Date Time pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
Patient 1Patient 1
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
5-Nov 15:00 100 2000 4.0 1.7 100
5-Nov 15:05 100 2000 4.1 1.7 100 0.38
Date Time pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
Systemic total Ca
Base excess
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
5-Nov 15:00 100 2000 4.0 1.7 100
5-Nov 15:05 100 2000 4.1 1.7 100 0.38
5-Nov 21:00 0.22 1.06 2.24 +1.8 7.42
Systemic total Ca
Base excess
Date Time pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
5-Nov 15:00 100 2000 4.0 1.7 100
5-Nov 15:05 100 2000 4.1 1.7 100 0.38
5-Nov 21:00 100 2000 4.0 1.9 100 0.22 1.06 2.24 +1.8 7.42
pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
Systemic total Ca
Base excess
Date Time
Patient 1Patient 1
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
5-Nov 15:00 100 2000 4.0 1.7 100
5-Nov 15:05 100 2000 4.1 1.7 100 0.38
5-Nov 21:00 100 2000 4.0 1.9 100 0.22 1.06 2.24 +1.8 7.42
6-Nov 03:00 0.27 1.13 2.34 +1.8 7.43
pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
Systemic total Ca
Base excess
Date Time
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
5-Nov 15:00 100 2000 4.0 1.7 100
5-Nov 15:05 100 2000 4.1 1.7 100 0.38
5-Nov 21:00 100 2000 4.0 1.9 100 0.22 1.06 2.24 +1.8 7.42
6-Nov 03:00 100 2000 4.0 1.9 100 0.27 1.13 2.34 +1.8 7.43
Date Time pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
Systemic total Ca
Base excess
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
5-Nov 15:00 100 2000 4.0 1.7 100
5-Nov 15:05 100 2000 4.1 1.7 100 0.38
5-Nov 21:00 100 2000 4.0 1.9 100 0.22 1.06 2.24 +1.8 7.42
6-Nov 03:00 100 2000 4.0 1.9 100 0.27 1.13 2.34 +1.8 7.43
6-Nov 09:00 0.26 1.15 2.34 +3.7 7.48
Systemic total Ca
Base excess
Date Time pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
5-Nov 15:00 100 2000 4.0 1.7 100
5-Nov 15:05 100 2000 4.1 1.7 100 0.38
5-Nov 21:00 100 2000 4.0 1.9 100 0.22 1.06 2.24 +1.8 7.42
6-Nov 03:00 100 2000 4.0 1.9 100 0.27 1.13 2.34 +1.8 7.43
6-Nov 09:00 90 2000 4.0 1.9 100 0.26 1.15 2.34 +3.7 7.48
Systemic total Ca
Base excess
Date Time pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
5-Nov 15:00 100 2000 4.0 1.7 100
5-Nov 15:05 100 2000 4.1 1.7 100 0.38
5-Nov 21:00 100 2000 4.0 1.9 100 0.22 1.06 2.24 +1.8 7.42
6-Nov 03:00 100 2000 4.0 1.9 100 0.27 1.13 2.34 +1.8 7.43
6-Nov 09:00 90 2000 4.0 1.9 100 0.26 1.15 2.34 +3.7 7.48
6-Nov 15:00 0.26 1.15 2.34 +2.2 7.44
pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
Systemic total Ca
Base excess
Date Time
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
5-Nov 15:00 100 2000 4.0 1.7 100
5-Nov 15:05 100 2000 4.1 1.7 100 0.38
5-Nov 21:00 100 2000 4.0 1.9 100 0.22 1.06 2.24 +1.8 7.42
6-Nov 03:00 100 2000 4.0 1.9 100 0.27 1.13 2.34 +1.8 7.43
6-Nov 09:00 90 2000 4.0 1.9 100 0.26 1.15 2.34 +3.7 7.48
6-Nov 15:00 90 2000 4.0 1.9 100 0.26 1.15 2.34 +2.2 7.44
Date Time pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
Systemic total Ca
Base excess
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
5-Nov 15:00 100 2000 4.0 1.7 100
pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
Systemic total Ca
Base excess
Date Time
Patient 2Patient 2
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
5-Nov 15:00 100 2000 4.0 1.7 100
5-Nov 15:05 0.27
Date Time pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
Systemic total Ca
Base excess
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
5-Nov 15:00 100 2000 4.0 1.7 100
5-Nov 15:05 100 2000 4.0 1.7 100 0.27
Systemic total Ca
Base excess
Date Time pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
5-Nov 15:00 100 2000 4.0 1.7 100
5-Nov 15:05 100 2000 4.0 1.7 100 0.27
5-Nov 21:00 0.18 1.02 2.34 -1.2 7.37
pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
Systemic total Ca
Base excess
Date Time
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
5-Nov 15:00 100 2000 4.0 1.7 100
5-Nov 15:05 100 2000 4.0 1.7 100 0.27
5-Nov 21:00 100 2000 3.8 2.1 100 0.18 1.02 2.34 -1.2 7.37
Date Time pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
Systemic total Ca
Base excess
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
5-Nov 15:00 100 2000 4.0 1.7 100
5-Nov 15:05 100 2000 4.0 1.7 100 0.27
5-Nov 21:00 100 2000 3.8 2.1 100 0.18 1.02 2.34 -1.2 7.37
6-Nov 03:00 0.22 1.05 2.42 -1.8 7.36
Systemic total Ca
Base excess
Date Time pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
Patient 2Patient 2
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
5-Nov 15:00 100 2000 4.0 1.7 100
5-Nov 15:05 100 2000 4.0 1.7 100 0.27
5-Nov 21:00 100 2000 3.8 2.1 100 0.18 1.02 2.34 -1.2 7.37
6-Nov 03:00 100 2000 3.7 2.3 100 0.22 1.05 2.42 -1.8 7.36
Systemic total Ca
Base excess
Date Time pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
5-Nov 15:00 100 2000 4.0 1.7 100
5-Nov 15:05 100 2000 4.0 1.7 100 0.27
5-Nov 21:00 100 2000 3.8 2.1 100 0.18 1.02 2.34 -1.2 7.37
6-Nov 03:00 100 2000 3.7 2.3 100 0.22 1.05 2.42 -1.8 7.36
6-Nov 09:00 0.25 1.08 2.46 -2.9 7.33
pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
Systemic total Ca
Base excess
Date Time
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
5-Nov 15:00 100 2000 4.0 1.7 100
5-Nov 15:05 100 2000 4.0 1.7 100 0.27
5-Nov 21:00 100 2000 3.8 2.1 100 0.18 1.02 2.34 -1.2 7.37
6-Nov 03:00 100 2000 3.7 2.3 100 0.22 1.05 2.42 -1.8 7.36
6-Nov 09:00 110 2000 3.7 2.3 100 0.25 1.08 2.46 -2.9 7.33
Date Time pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
Systemic total Ca
Base excess
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
5-Nov 15:00 100 2000 4.0 1.7 100
5-Nov 15:05 100 2000 4.0 1.7 100 0.27
5-Nov 21:00 100 2000 3.8 2.1 100 0.18 1.02 2.34 -1.2 7.37
6-Nov 03:00 100 2000 3.7 2.3 100 0.22 1.05 2.42 -1.8 7.36
6-Nov 09:00 110 2000 3.7 2.3 100 0.25 1.08 2.46 -2.9 7.33
6-Nov 15:00 0.23 1.12 2.52 -0.9 7.38
Systemic total Ca
Base excess
Date Time pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
5-Nov 15:00 100 2000 4.0 1.7 100
5-Nov 15:05 100 2000 4.0 1.7 100 0.27
5-Nov 21:00 100 2000 3.8 2.1 100 0.18 1.02 2.34 -1.2 7.37
6-Nov 03:00 100 2000 3.7 2.3 100 0.22 1.05 2.42 -1.8 7.36
6-Nov 09:00 110 2000 3.7 2.3 100 0.25 1.08 2.46 -2.9 7.33
6-Nov 15:00 110 2000 3.6 2.3 100 0.23 1.12 2.52 -0.9 7.38
pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
Systemic total Ca
Base excess
Date Time
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
5-Nov 15:00 100 2000 4.0 1.7 100
5-Nov 15:05 100 2000 4.0 1.7 100 0.27
5-Nov 21:00 100 2000 3.8 2.1 100 0.18 1.02 2.34 -1.2 7.37
6-Nov 03:00 100 2000 3.7 2.3 100 0.22 1.05 2.42 -1.8 7.36
6-Nov 09:00 110 2000 3.7 2.3 100 0.25 1.08 2.46 -2.9 7.33
6-Nov 15:00 110 2000 3.6 2.3 100 0.23 1.12 2.52 -0.9 7.38
6-Nov 21:00 0.26 1.06 2.52 -1.2 7.39
Date Time pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
Systemic total Ca
Base excess
Patient 2Patient 2
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
5-Nov 15:00 100 2000 4.0 1.7 100
5-Nov 15:05 100 2000 4.0 1.7 100 0.27
5-Nov 21:00 100 2000 3.8 2.1 100 0.18 1.02 2.34 -1.2 7.37
6-Nov 03:00 100 2000 3.7 2.3 100 0.22 1.05 2.42 -1.8 7.36
6-Nov 09:00 110 2000 3.7 2.3 100 0.25 1.08 2.46 -2.9 7.33
6-Nov 15:00 110 2000 3.6 2.3 100 0.23 1.12 2.52 -0.9 7.38
6-Nov 21:00 110 2000 3.6 2.5 100 0.26 1.06 2.52 -1.2 7.39
Systemic total Ca
Base excess
Date Time pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
5-Nov 15:00 100 2000 4.0 1.7 100
5-Nov 15:05 100 2000 4.0 1.7 100 0.27
5-Nov 21:00 100 2000 3.8 2.1 100 0.18 1.02 2.34 -1.2 7.37
6-Nov 03:00 100 2000 3.7 2.3 100 0.22 1.05 2.42 -1.8 7.36
6-Nov 09:00 110 2000 3.7 2.3 100 0.25 1.08 2.46 -2.9 7.33
6-Nov 15:00 110 2000 3.6 2.3 100 0.23 1.12 2.52 -0.9 7.38
6-Nov 21:00 110 2000 3.6 2.5 100 0.26 1.06 2.52 -1.2 7.39
7-Nov 03:00 0.26 1.10 2.63 -1.0 7.38
pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
Systemic total Ca
Base excess
Date Time
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
5-Nov 15:00 100 2000 4.0 1.7 100
5-Nov 15:05 100 2000 4.0 1.7 100 0.27
5-Nov 21:00 100 2000 3.8 2.1 100 0.18 1.02 2.34 -1.2 7.37
6-Nov 03:00 100 2000 3.7 2.3 100 0.22 1.05 2.42 -1.8 7.36
6-Nov 09:00 110 2000 3.7 2.3 100 0.25 1.08 2.46 -2.9 7.33
6-Nov 15:00 110 2000 3.6 2.3 100 0.23 1.12 2.52 -0.9 7.38
6-Nov 21:00 110 2000 3.6 2.5 100 0.26 1.06 2.52 -1.2 7.39
7-Nov 03:00 110 2000 3.6 2.7 100 0.26 1.10 2.63 -1.0 7.38
Date Time pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
Systemic total Ca
Base excess
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
5-Nov 15:00 100 2000 4.0 1.7 100
5-Nov 15:05 100 2000 4.0 1.7 100 0.27
5-Nov 21:00 100 2000 3.8 2.1 100 0.18 1.02 2.34 -1.2 7.37
6-Nov 03:00 100 2000 3.7 2.3 100 0.22 1.05 2.42 -1.8 7.36
6-Nov 09:00 110 2000 3.7 2.3 100 0.25 1.08 2.46 -2.9 7.33
6-Nov 15:00 110 2000 3.6 2.3 100 0.23 1.12 2.52 -0.9 7.38
6-Nov 21:00 110 2000 3.6 2.5 100 0.26 1.06 2.52 -1.2 7.39
7-Nov 03:00 110 2000 3.6 2.7 100 0.26 1.10 2.63 -1.0 7.38
7-Nov 09:00 0.22 1.03 2.65 -2.0 7.35
Systemic total Ca
Base excess
Date Time pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
Treatment stopped due to citrate accumulationTreatment stopped due to citrate accumulation
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
16-Mai 15:50 100 1500 4.1 1.7 100
Systemic total Ca
Base excess
Date Time pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
16-Mai 15:50 100 1500 4.1 1.7 100 0,25 1.15 2.13 -3.5 7.36
pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
Systemic total Ca
Base excess
Date Time
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
16-Mai 15:50 100 1500 4.1 1.7 100 0,25 1.15 2.13 -3.5 7.36
16-Mai 17:00device defect 1.15
notmeasured -3.6 7.37
Systemic total Ca
Base excess
Date Time pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
Patient 3Patient 3
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
16-Mai 15:50 100 1500 4.1 1.7 100 0,25 1.15 2.13 -3.5 7.36
16-Mai 17:00 100 1500 4.1 1.7 100device defect 1.15
notmeasured -3.6 7.37
pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
Systemic total Ca
Base excess
Date Time
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
16-Mai 15:50 100 1500 4.1 1.7 100 0,25 1.15 2.13 -3.5 7.36
16-Mai 17:00 100 1500 4.1 1.7 100device defect 1.15
notmeasured -3.6 7.37
16-Mai 20:00 0,26 1.12not
measured -4.3 7.32
Date Time pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
Systemic total Ca
Base excess
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
16-Mai 15:50 100 1500 4.1 1.7 100 0,25 1.15 2.13 -3.5 7.36
16-Mai 17:00 100 1500 4.1 1.7 100device defect 1.15
notmeasured -3.6 7.37
16-Mai 20:00 100 1500 4.1 1.7 100 0,26 1.12not
measured -4.3 7.32
Systemic total Ca
Base excess
Date Time pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
16-Mai 15:50 100 1500 4.1 1.7 100 0,25 1.15 2.13 -3.5 7.36
16-Mai 17:00 100 1500 4.1 1.7 100device defect 1.15
notmeasured -3.6 7.37
16-Mai 20:00 100 1500 4.1 1.7 100 0,26 1.12not
measured -4.3 7.32
17-Mai 06:40 100 1500 3.6 2.2 110 0,19 1.03 2.21 -2.3 7.34
17-Mai 09:00 100 1500 3.6 2.2 110 0,29 1.03not
measured -4.2 7.35
17-Mai 19:10 100 1500 3.7 2.2 110 0,22 1.12not
measured -2.9 7.38
17-Mai 20:00 100 1500 3.5 2.2 110 0,22 1.15not
measured -1.5 7.41
Systemic total Ca
Base excess
Date Time pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
Patient 3Patient 3
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
16-Mai 15:50 100 1500 4.1 1.7 100 0,25 1.15 2.13 -3.5 7.36
16-Mai 17:00 100 1500 4.1 1.7 100device defect 1.15
notmeasured -3.6 7.37
16-Mai 20:00 100 1500 4.1 1.7 100 0,26 1.12not
measured -4.3 7.32
17-Mai 06:40 100 1500 3.6 2.2 110 0,19 1.03 2.21 -2.3 7.34
17-Mai 09:00 100 1500 3.6 2.2 110 0,29 1.03not
measured -4.2 7.35
17-Mai 19:10 100 1500 3.7 2.2 110 0,22 1.12not
measured -2.9 7.38
17-Mai 20:00 100 1500 3.5 2.2 110 0,22 1.15not
measured -1.5 7.41
18-Mai 02:00 100 1500 3.5 2.2 110 0,25 1.16 2.20 -0.5 7.43
18-Mai 09:00 100 1500 3.5 2.2 110 0,25 1.15not
measured +1.5 7.45
18-Mai 10:05 100 1500 3.5 2.2 110 0,26 1.15not
measured +1.8 7.44
18-Mai 20:00 100 1500 3.5 2.2 110 0,25 1.16not
measured +0.2 7.42
pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
Systemic total Ca
Base excess
Date Time
dd.mm hh:mm ml/min ml/h mmol/l mmol/l ml/h mmol/l mmol/l mmol/l mmol/l pH-units
16-Mai 15:50 100 1500 4.1 1.7 100 0,25 1.15 2.13 -3.5 7.36
16-Mai 17:00 100 1500 4.1 1.7 100device defect 1.15
notmeasured -3.6 7.37
16-Mai 20:00 100 1500 4.1 1.7 100 0,26 1.12not
measured -4.3 7.32
17-Mai 06:40 100 1500 3.6 2.2 110 0,19 1.03 2.21 -2.3 7.34
17-Mai 09:00 100 1500 3.6 2.2 110 0,29 1.03not
measured -4.2 7.35
17-Mai 19:10 100 1500 3.7 2.2 110 0,22 1.12not
measured -2.9 7.38
17-Mai 20:00 100 1500 3.5 2.2 110 0,22 1.15not
measured -1.5 7.41
18-Mai 02:00 100 1500 3.5 2.2 110 0,25 1.16 2.20 -0.5 7.43
18-Mai 09:00 100 1500 3.5 2.2 110 0,25 1.15not
measured +1.5 7.45
18-Mai 10:05 100 1500 3.5 2.2 110 0,26 1.15not
measured +1.8 7.44
18-Mai 20:00 100 1500 3.5 2.2 110 0,25 1.16not
measured +0.2 7.42
19-Mai 04:00 100 1500 3.5 1.9 110 0,27 1.23not
measured +3.0 7.44
19-Mai 08:00 100 1500 3.5 1.9 110 0,27 1.27not
measured +3.0 7.44
19-Mai 10:00
Base excess
Date Time
Retransfusion, CVVHD dismantled
pHBlood flow
Dialy-sate
Citrate dose
Calciumdose
Net-UF Postfilter ionised
Ca
Systemic ionised
Ca
Systemic total Ca
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