Figure 4.
Simulated systemic citrate level curves with three different postdilution continuous venovenous hemodiafiltration with regional citrate anticoagulation (CVVHDF-RCA) prescriptions as a function of time and citrate metabolism. With precalculated Shock settings, very high filter effluent flows relative to circuit plasma flow ensure >0.75 single-pass fractional dialyzer citrate removal (ECit) and prevent maximum systemic citrate accumulation (CMax) ≥2.5 mM even in the absence of liver metabolism. CRRT, continuous RRT.