| | Systemic Albumin Level (g/dL) |
|---|
Effluent Flow ml/hour | 0.0–0.7 g/dL | 0.8–1.2 g/dL | 1.3–1.7 g/dL | 1.8–2.2 g/dL | 2.3–2.7 g/dL | 2.8–3.2 g/dL | 3.3–3.7 g/dL | 3.8–4.2 g/dL | 4.3–4.7 g/dL | 4.8–5.2 g/dL |
|---|
<=1400 | 16 | 17 | 17 | 18 | 19 | 19 | 20 | 20 | 21 | 21 |
1401–1700 | 20 | 20 | 21 | 22 | 23 | 23 | 24 | 25 | 25 | 26 |
1701–2000 | 23 | 24 | 25 | 26 | 27 | 28 | 28 | 29 | 30 | 31 |
2001–2300 | 26 | 27 | 28 | 30 | 31 | 32 | 32 | 33 | 34 | 35 |
2301–2600 | 32 | 33 | 34 | 35 | 37 | 38 | 39 | 40 | 41 | 42 |
2601–2900 | 35 | 37 | 38 | 39 | 41 | 42 | 43 | 44 | 45 | 46 |
2901–3200 | 38 | 40 | 42 | 43 | 44 | 46 | 47 | 48 | 50 | 51 |
3201–3500 | 42 | 43 | 45 | 47 | 48 | 50 | 51 | 53 | 54 | 55 |
3501–3800 | 45 | 47 | 48 | 50 | 52 | 54 | 55 | 57 | 58 | 60 |
3801–4100 | 48 | 50 | 52 | 54 | 56 | 57 | 59 | 61 | 63 | 64 |
4101–4400 | 51 | 53 | 55 | 57 | 59 | 61 | 63 | 65 | 67 | 68 |
- Footnote: For patients with expected good to fair citrate metabolism the initial Ca infusion rate is prescribed by the nephrology team based on the effluent flow row (=QACDA+ QD+ QRF+ Net UF) and the last measured systemic serum albumin column. Calcium replacement is the product of the plasma Ca-clearance times the goal serum total Ca level. The patient’s serum albumin level determines the target plasma total Ca level needed to keep the plasma iCa around 1.05–1.25 mmol/L with systemic citrate clearance estimated at about 15 L/hour and systemic citrate level estimated in the 0.7–1.4 mM range. To target a higher systemic iCa of 1.3 mM (at the ICU team’s discretion) simply multiply by 1.13 the initial Ca-infusion rate derived from Table 2 (which is designed for goal systemic iCa 1.15 mM)
- Abbreviations: g/dL grams per deciliter, ml/hour milliliter per hour, QCa Calcium infusion rate, QACDA Acid citrate dextrose anticoagulant infusion rate, QD dialysate flow rate, QRF replacement fluid flow rate, Net UF machine set net ultrafiltration rate
