Upgrading Renal Replacement Therapy Machines in the ICU: A Comparative Observational Study of Heparin vs. Regional Citrate Anticoagulation

BACKGROUND: Continuous renal replacement therapy (CRRT) requires effective anticoagulation to prevent circuit clotting. This study compared heparin and regional citrate anticoagulation (RCA) in an Intensive Care Unit (ICU), focusing on patient safety, cost-effectiveness, and nursing perspectives. METHODS: This retrospective observational study included ICU patients undergoing CRRT with heparin (December 2021 - March 2022) and RCA (June 2022 - September 2022). Outcomes assessed were CRRT duration per patient, filter set cost, lifespan, and blood transfusion requirements. Data were extracted from electronic health records and analyzed using IBM SPSS Statistics Version 29. RESULTS: RCA significantly increased CRRT duration per patient (198 vs. 101 hours, p = 0.037) and filter lifespan (67 vs. 24 hours, p < 0.001) compared to heparin. Filter cost per renal day decreased from £98.05 with heparin to £57.48 with RCA (p = 0.04). Blood transfusion requirements reduced from 0.59 to 0.27 transfusions per renal day, lowering daily transfusion costs from £84.96 to £39.58 with RCA. CONCLUSION: RCA demonstrated clinical and economic benefits in CRRT compared to heparin, including improved filter longevity, reduced transfusion requirements, and overall cost savings. CLINICAL SIGNIFICANCE: Implementation of RCA in CRRT can enhance treatment efficacy, reduce nursing interventions, and improve resource utilization in ICU settings.