Regional Citrate CRRT — FRCA Final MCQ

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ModerateIntensive Care MedicineRegional Citrate CRRTFRCA Final

CRRT circuit clotting every 4-6h despite systemic heparin. Recommended alternative?

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Correct answer: A — Regional citrate anticoagulation

RCA is KDIGO-recommended first-line for CRRT. Citrate chelates calcium in circuit (prevents coagulation); systemic calcium replaced via separate infusion. Extends circuit life, avoids systemic anticoagulation. Monitor total:ionised Ca ratio (>2.5 = accumulation in liver failure).

Reference: KDIGO – 2024 – CRRT anticoagulation