Unique Plan Description: Calcium Citrate Anticoagulation Protocol
Plan Selection Display: Calcium Citrate Anticoagulation Protocol
PlanType: Medical                                 
Version: 2          
Begin Effective Date: 2024-03-18 11:47:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2024-03-18 11:47:00
Available at all facilities: Yes

Calcium Citrate Anticoagulation Protocol
Laboratory
	Post Filter Ionized Calcium
		T;N, Q6H, Timed, spec type = CRRT Filter Blood
	Ionized Calcium
		T;N, Timed, Q6H, spec type = Blood
IV Solutions
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	anticoagulant citrate dextrose - CRRT
		1,000 mL, Dialysis, 150 ml/hr
			Comment: Titrate based on post-filter ionized calcium.Post-filter ionized Ca < 0.25 mmol/L = decrease rate by 10mL/hr.Post-filter ionized Ca 0.25-0.35 mmol/L (goal range) = No change.Post-filter ionized Ca 0.36-0.45mmol/L = Increase rate by 10mL/hr.Post-filter ionized Ca >0.45 mmol/L = Increase rate by 20mL/hr.If anticoagulant citrate dextrose infusion is interrupted, please clarify with provider regarding restarting infusion and rate of infusion. If CRRT stopped for any reason, stop anticoagulant citrate infusion and clarify with provider regarding restarting infusion and rate of infusion.
	Calcium Chloride 6gm/1000mL D5W
		6,000 mg, EVERY BAG
		1,000 mL, IV, 60 ml/hr
			Comment: Titrate based on Systemic ionized calcium (mmol/L).Systemic ionized Ca > 1.3 mmol/L = decrease rate by 10mL/hr.Systemic ionized Ca 1.1-1.3 mmol/L (goal range) = No change.Systemic ionized Ca 0.9-1.1 mmol/L = Increase rate by 10mL/hr.Systemic ionized Ca < 0.9 mmol/L = Increase rate by 20mL/hr.If calcium chloride infusion is interrupted, please clarify with provider regarding restarting infusion and rate of infusion. If CRRT stopped for any reason, stop calcium chloride infusion and clarify with provider regarding restarting infusion and rate of infusion.

*Report Legend:
DEF - This order sentence is the default for the selected order
GOAL - This component is a goal
IND - This component is an indicator
INT - This component is an intervention
IVS - This component is an IV Set
NOTE - This component is a note
Rx - This component is a prescription
SUB - This component is a sub phase