Hello everybody. i have a question about standard ACD-A solution. how much citrate (mmol/L) does ACD-A solution contain? 75 mmol/L ? or 110 mmol/L? i could not understand it.
In an ACD-A bag the concentration of citrate is 75 mmol/l. But there is also citric acid, at 38 mmol/l. They are in an equilibrium. Removing citrate (by metabolism when infused) then leads to citric acid turning to citrate.
The most commonly used citrate formulations in apheresis are Acid-Citrate-Dextrose Formula A (ACD-A) and ACD-B.
ACD-A contains 3% citrate (112 mmol/L of citrate or 21.3 mg/mL) whereas ACD-B has a reduced citrate concentration of 2% citrate (68 mmol/L or 12.8 mg/mL).
References
Lee G, Arepally GM. Anticoagulation techniques in apheresis: from heparin to citrate and beyond. J Clin Apher. 2012;27(3):117-125. doi:10.1002/jca.21222
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