Citrate pathophysiology and metabolism.

Mehran Monchi

Journal: Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis 2017;56(1):28-30

PMID: 28073690

Full Text on Elsevier Science View on PubMed

Abstract

By chelating ionized calcium, citrate allows extracorporeal circuit anticoagulation without a bleeding risk for the patient. Citrate anticoagulation is also associated with a reduced activation of leucocytes and platelets. Citrate clearance by citric acid cycle (Krebs cycle) is not modified by renal failure, but is reduced by about 50% in patients with cirrhosis. Toxic effects of citrate result from a decrease in plasma ionized calcium of the patient. The first side effect is a prolongation of the QT interval. Clinical signs of hypocalcemia and hypotension in humans appear below 0.9mmol/L of plasma ionized calcium.

Address: Intensive care deparment, Centre Hospitalier de Melun, Melun, F-77000, France. Electronic address: [email protected].

DOI: 10.1016/j.transci.2016.12.013

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MeSH Terms: Anticoagulants, Blood Coagulation, Citric Acid, Humans