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Citrate Toxicity: Experienced when ionized calcium levels are low due to citrate anticoagulation which binds to free calcium in the blood resulting in hypocalcemia. [1] [2] [5] [8] [9] Pediatric considerations to reduce incidences [spelling?] of citrate toxicity: Infusion of intravenous calcium during treatment. [2] [7] [8]
A citrate is a derivative of citric acid; that is, the salts, esters, and the polyatomic anion found in solutions and salts of citric acid. An example of the former, a salt is trisodium citrate; an ester is triethyl citrate. When citrate trianion is part of a salt, the formula of the citrate trianion is written as C 6 H 5 O 3− 7 or C 3 H 5 O ...
Plasmapheresis (from the Greek πλάσμα, plasma, something molded, and ἀφαίρεσις aphairesis, taking away) is the removal, treatment, and return or exchange of blood plasma or components thereof from and to the blood circulation. It is thus an extracorporeal therapy, a medical procedure performed outside the body. [1]
Routine use of fresh frozen plasma (FFP) is not generally appropriate because of the dangers including citrate toxicity (from the anticoagulant), ABO incompatibility, infection, and allergic reactions. However, FFP should be used in cases of thrombotic thrombocytopenic purpura or patients at high risk of bleeding.
This therapy is meant for fluoroacetate (FA) poisoning which is highly related MFA, so this therapy aimed at MFA may result in other outcomes. [8] Treatment with monoacetin (glycerol monoacetate) helped against FA poisoning. It aids in increasing acetate levels of the blood and it decreases citrate levels in the heart, brain, and kidneys.
Sodium citrate is used to prevent donated blood from clotting in storage, and can also be used as an additive for apheresis to prevent clots forming in the tubes of the machine. By binding with calcium ions in the blood it prevents the process of coagulation. It is also used as an anticoagulant for laboratory testing, in that blood samples are ...
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Use of ACD is universal for centrifuge-based systems, while membrane systems may use either. Heparin is still used for high-volume procedures, as infusing too much citrate with the returned blood can cause toxicity from the chelating action, mainly hypocalcemia. [9]