International Journal of Nursing Research

Objective To systematically evaluate the effect of topical sodium citrate anticoagulation in patients with hemofiltration. Methods CNKI, Wanfang database, VIP database, PubMed, EMbase, CBM were searched by computer, and the included literatures and related review literatures were retrospectively included. Randomized controlled trials (RCTs) and retrospective analysis on the efficacy of topical sodium citrate anticoagulation versus low molecular weight heparin anticoagulation in hemofiltration patients were collected. The experimental group was treated with local sodium citrate anticoagulation, and the control group was treated with low molecular weight heparin. The retrieval period will be established until May 1, 2021. Two researchers screened the literature according to the inclusion and exclusion criteria, and extracted data to evaluate the risk of bias in the included studies. Main outcome indicator: bleeding events, filter use time, activated partial thromboplastin time, sodium ion, calcium ion, pH, creatinine, C-reactive protein, publication bias. Results A total of 11 studies were included, including 455 patients treated with topical sodium citrate anticoagulation and 484 patients treated with low molecular weight heparin anticoagulation. The results of meta-analysis showed that compared with the control group, the experimental group significantly increased the use time of the filter in hemofiltration patients (Z=27.23, P<0.001), reduced the incidence of bleeding events (Z=4.23, P<0.001), and reduced the level of APTT (Z=15.53, P<0.001), free Na+ levels (Z=3.95, P<0.001), Scr levels (Z=8.32, P<0.001) and CRP levels (Z=15.87, P<0.001), free Ca2+ levels (Z=0.19, P=0.85) and pH levels (Z=1.55, P=0.12) there was no statistical difference. Conclusion Compared with low molecular weight heparin anticoagulation, local sodium citrate has better anticoagulation effect, can effectively reduce the incidence of bleeding events, prolong the service life of filters, reduce inflammatory response, and improve the coagulation function of the body, which is worthy of promotion.

Hemofiltration; Topical sodium citrate anticoagulation; Bleeding events; Coagulation function; Meta-analysis