citrate + normocarb

This is a combination therapy used in continuous renal replacement therapy (CRRT), particularly for patients requiring regional anticoagulation. Citrate acts as an anticoagulant by chelating calcium in the extracorporeal circuit, thereby preventing clot formation within the dialysis filter. Normocarb HF is a sterile, nonpyrogenic electrolyte concentrate containing sodium chloride, magnesium chloride hexahydrate, and sodium bicarbonate; it is used as a replacement solution to restore water and correct electrolyte and acid-base imbalances during CRRT. The combination of citrate with Normocarb allows for effective anticoagulation while maintaining physiological electrolyte balance and buffering capacity through bicarbonate[1][2][3][4]. Citrate must be carefully managed to avoid hypocalcemia or metabolic alkalosis; calcium is typically infused separately to counteract systemic effects[5].