Bioenergetic gain of citrate anticoagulated continuous hemodiafiltration-a comparison between 2 citrate modalities and unfractionated heparin

The bioenergetic gain of CVVHDF comes from glucose (in ACD), lactate and citrate. The amount substantially differs between modalities despite a similar CVVHDF dose and is unacceptably high when using ACD with calcium-containing lactate-buffered solutions and a higher blood flow. When calculating nutritional needs, we should account for the energy delivered by CVVHDF.