Anticoagulant effects of different calcium supplementation pathways in calcium-free RCA-CVVH: a study protocol for a prospective randomized cross-over trial

Background When regional citrate anticoagulation used in continuous renal replacement therapy, one of the key aspects to achieve safe and effective extracorporeal circulation is the management of calcium ions. For calcium-free RCA-CVVH, the anticoagulant effects of different calcium supplementation pathways have not yet been explored. In this trial, we would test our hypothesis that compared with the SCV, when calcium was infused through the VL-FV, the arterial iCa2+ was lower. Methods This is a prospective randomized cross-over trial involving 24 patients undergoing RCA-CVVH. The patients were randomly divided into two groups: VL-FV—SCV group and SCV—VL-FV group. The difference of iCa2+ between arterial iCa2+ and post-filtration iCa2+ was compared. Secondary indicators included the incidence rates of catheter dysfunction and hypocalcemia. Discussion This is the first trial on the anticoagulant effects of calcium-free RCA-CVVH through different calcium supplement routes. We will confirm that the arterial iCa2 + level is slightly lower when calcium is infused in the VL-FV than in the SCV, and the incidence rates of catheter dysfunction and hypocalcemia will help us to determine which site is safer. Trial Registration CHiCTR registry: ChiCTR1800020046. Registered on 12 December 2018. (http://www.chictr.org.cn/listbycreater.aspx). Keywords: Continuous venous-venous hemofiltration, regional citrate anticoagulation, calcium, effect, safety, cross-over trial

KAJIAN EFEKTIVITAS KALSIUM UNTUK PENGEMBANGAN TEKNOLOGI INTENSIF PADA BUDIDAYA LOBSTER AIR TAWAR (Cherax quadricarinatus)

Dalam proses pertumbuhan lobster dibutuhkan mineral kalsium (Ca) yang dapat dicukupi dari makanan dan lingkungan. Pada fase pengerasan kulit diperlukan kalsium yang cukup tinggi. Kebutuhan akan kalsium tidak dapat dipenuhi dari dalam tubuhnya yang tersimpan di dalam hemolimf. Oleh karena itu, diperlukan kajian tentang efektivitas mineral kalsium di dalam air pada budidaya lobster. Penelitian dilakukan secara in door pada bak semen yang dilengkapi dengan sistem resirkulasi. Rancangan penelitian dilakukan dengan menggunakan Rancangan Acak Lengkap dengan 4 perlakuan konsentrasi penambahan calcium hydroxyde ke dalam media yaitu 0 mg/L, 5 mg/L, 10 mg/L, dan 15 mg/L. Masing-masing perlakuan mendapat 3 ulangan. Hasil penelitian menunjukkan bahwa efek pemberian kalsium (CaOH2) pada lobster tawar terlihat secara signifikan memberikan efek yang positif dan jauh lebih baik dibandingkan dengan kontrol (P<0,05). Konsentrasi kalsium 5,0–10,0 mg/L memberikan hasil yang baik dalam mempengaruhi pertumbuhan lobster. Hasil yang diperoleh dari penelitian ini membuktikan bahwa manajemen dalam konsentrasi kalsium yang seimbang pada media pemeliharaan lobster dapat diaplikasikan sehingga budidaya lobster dapat dilaksanakan secara intensif.Calcium mineral was need to support of lobster growth it’s sufficient from feed and environment. Phase of harden carapace was need a high calcium. The calcium need did not fulfilled by hemolymphe body. And then the assessment of calcium effect was conducted to lobster culture. Complete randomized design was used for this research with different level of calcium hydroxide to the media namely 0.0 mg/L, 5.0 mg/L, 10.0 mg/L, and 15.0 mg/L. The experiment was conducted in the completely randomized design with three replications. Result of this experiment showed that there were significant different positively compared than control (P<0.05). Calcium level of 5.0-10.0 mg/L indicated positively affect to the growth of lobster. Result of this experiment to prove that management of calcium in the media rearing can be used to intensive culture of lobster.