Ci-Ca Therapy

Less bleeding complications due to safe citrate anticoagulation.

Photo: Ci-Ca Therapy

Ci-Ca Therapy is a continuous renal replacement therapy-method for safe regional anticoagulation. The therapy system, from Fresenius Medical Care, has an integrated citrate and calcium management form. The citrate forms chelate complexes with ionised calcium contained in the blood, hence reducing its concentration, which leads to an effective anticoagulation in the extracorporeal circuit. In addition, the infused citrate is eliminated partly by diffusion and metabolism, which avoids systemic anticoagulation.

The advantage of citrate compared with other anticoagulants (e.g. Heparin, the most frequently used anticoagulant) is the regional anticoagulation. Heparin, for example, is applied systemically and this results in anticoagulation of the entire organism. This can be dangerous especially with active bleeding or bleeding diathesis patients. With Ci-Ca there is a clearly reduced risk of bleeding complications compared with systemic anticoagulation therapies.

An effective treatment, targeted influencing of the acid-base status, and an easy adjustment of the treatment dose, are some special features of Ci-Ca CVVHD, Fresenius adds.

Management of the acid base balance
The serum bicarbonate concentration can specifically be influenced by the ratio of blood to dialysis solution flow. An increase in the dialysis solution flow facilitates the compensation of a metabolic alkalosis. In case of metabolic acidosis, the acid-base status can be normalised by increasing blood flow.

The multiFiltrate Ci-CA Cassette – This is safe and easy to use due to the integrated citrate and calcium lines, colour-coded components to avoid error, and specific connectors for citrate and calcium.


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