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Mathematical modelling of post-filter ionized calcium during citrate anticoagulated continuous renal replacement therapy

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  • Innas Forsal
  • Anders Nilsson
  • Mikael Bodelsson
  • Anders Wieslander
  • Marcus Broman

Abstract

Background/Aims: Post-filter ionized calcium (iCa) measured on a blood gas analyzer (BGA) during regional citrate anticoagulated continuous renal replacement therapy (CRRT) are needed to control the regime. This increases the workload and requires attention including interpretation of blood analyses. Two algorithms were developed to calculate the post-filter iCa instead. The first algorithm used measured systemic total calcium and the second used a selected set of values from an initial blood gas sample as input. Methods: Calculated post-filter iCa values were compared to real blood gas analyses. 57 patients treated at the intensive care unit at Skåne University Hospital in Lund during 2010–2017 were included after applying inclusion and exclusion criteria. Clinical and machine parameters were collected from the electronic medical records. Non-quality checked data contained 1240 measurements and quality checked data contained 1034 measurements. Results: The first algorithm using measured systemic total calcium resulted in slightly better precision and trueness with an average difference between the predicted and measured post-filter iCa concentration of 0.0185±0.0453 mmol/L for quality checked data, p

Suggested Citation

  • Innas Forsal & Anders Nilsson & Mikael Bodelsson & Anders Wieslander & Marcus Broman, 2021. "Mathematical modelling of post-filter ionized calcium during citrate anticoagulated continuous renal replacement therapy," PLOS ONE, Public Library of Science, vol. 16(2), pages 1-16, February.
    • Handle: RePEc:plo:pone00:0247477
    DOI: 10.1371/journal.pone.0247477
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    1. Yin Zheng & Zhongye Xu & Qiuyu Zhu & Junfeng Liu & Jing Qian & Huaizhou You & Yong Gu & Chuanming Hao & Zheng Jiao & Feng Ding, 2013. "Citrate Pharmacokinetics in Critically Ill Patients with Acute Kidney Injury," PLOS ONE, Public Library of Science, vol. 8(6), pages 1-7, June.
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