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

Forsal, Innas LU ; Nilsson, Anders ; Bodelsson, Mikael LU ; Wieslander, Anders and Broman, Marcus LU (2021) In PLoS ONE 16(2 February 2021).
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... (More)

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<0.001. Neither algorith could detect all instances requiring intervention. Conclusion The algorithms were able to estimate in range postfilter iCa values with great trueness and precision. However, they had some difficulties to estimate out-of-range postfilter iCa values. More work is needed to improve the algorithms especially in their citrate-modelling.

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author
; ; ; and
publishing date
type
Contribution to journal
publication status
published
subject
in
PLoS ONE
volume
16
issue
2 February 2021
article number
e0247477
publisher
Public Library of Science (PLoS)
external identifiers
  • scopus:85102151535
  • pmid:33630962
ISSN
1932-6203
DOI
10.1371/journal.pone.0247477
language
English
LU publication?
no
id
8dacd047-1af1-4b69-ba3f-d21ba3e84c6e
date added to LUP
2021-03-18 08:50:15
date last changed
2024-03-21 03:47:44
@article{8dacd047-1af1-4b69-ba3f-d21ba3e84c6e,
  abstract     = {{<p>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&lt;0.001. Neither algorith could detect all instances requiring intervention. Conclusion The algorithms were able to estimate in range postfilter iCa values with great trueness and precision. However, they had some difficulties to estimate out-of-range postfilter iCa values. More work is needed to improve the algorithms especially in their citrate-modelling.</p>}},
  author       = {{Forsal, Innas and Nilsson, Anders and Bodelsson, Mikael and Wieslander, Anders and Broman, Marcus}},
  issn         = {{1932-6203}},
  language     = {{eng}},
  number       = {{2 February 2021}},
  publisher    = {{Public Library of Science (PLoS)}},
  series       = {{PLoS ONE}},
  title        = {{Mathematical modelling of post-filter ionized calcium during citrate anticoagulated continuous renal replacement therapy}},
  url          = {{http://dx.doi.org/10.1371/journal.pone.0247477}},
  doi          = {{10.1371/journal.pone.0247477}},
  volume       = {{16}},
  year         = {{2021}},
}