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protocol 1.016 : Calcium Gluconate Infusion Titration in CRRT - Adult Critical Care

When sodium citrate is used during Continuous Renal Replacement Therapy (CRRT), a continuous calcium infusion must be utilized concomitantly. Sodium citrate is used as an anticoagulant during CRRT as to prevent clotting in the extracorporeal circuit. The citrate chelates ionized calcium, an essential cofactor in the clotting cascade, causing the calcium to be unavailable for clot formation. The citrate/calcium chelate is then dialyzed off and the blood returned to the patient is therefore very low in calcium. It is the responsibility of the bedside ICU nurse to maintain a serum Ionized Calcium level between 4.5-5.5 mg/ dl. This protocol is to ensure safe use of this therapeutic agent as a continuous infusion. [A Zomp, S Hertwig]

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  1. effective date:

    11/01/2013
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