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cvvhdf treatment

Maoqin Li, Zhidong Wang, Yining Wang, Changhong Du, Songhai Li, Zaixiang Shi, Bo Lu
The present study is a retrospective analysis of 11 cases with severe acute liver failure combined with multiple organ dysfunction syndrome (MODS) performed during the period June, 2012 to December, 2014. After part of plasmapheresis with plasma filtration adsorption combined with continuous hemodiafiltration treatment, good curative effects were obtained and the main clinical symptoms and biochemical index were significantly improved. Following treatment, 8 of the 11 patients survived at a survival rate of 72...
October 2016: Experimental and Therapeutic Medicine
Rebecca Fischler, Anne-Pascale Meert, Jean-Paul Sculier, Thierry Berghmans
INTRODUCTION: Acute renal failure (ARF) has a poor prognosis in patients with cancer requiring intensive care unit (ICU) admission. Our aim is finding prognostic factors for hospital mortality in patients with cancer with ARF requiring renal replacement therapy (RRT). METHODS: In this retrospective study, all patients with cancer with ARF treated with continuous venovenous filtration (CVVHDF) in the ICU of the Institut Jules Bordet, between January 1, 2003 and December 31, 2012, were included...
2016: Frontiers in Medicine
Ilias Karaiskos, Lena E Friberg, Lambrini Galani, Konstantinos Ioannidis, Emmanouela Katsouda, Zoe Athanassa, Harris Paskalis, Helen Giamarellou
Traditionally, reduced daily doses of colistin methanesulphonate (CMS) in critically ill patients receiving continuous venovenous haemodiafiltration (CVVHDF) have resulted in suboptimal colistin concentrations. The necessity of a loading dose (LD) at treatment initiation has been proposed. A LD of 9 million IU (MU) [ca. 270 mg of colistin base activity (CBA)] was administrated with a maintenance dose of 4.5 MU (ca. 140 mg CBA) every 12 h (q12h) to eight critically ill patients receiving renal replacement therapy...
September 2016: International Journal of Antimicrobial Agents
Hugh Davies, Gavin D Leslie, David Morgan
INTRODUCTION: An effect of severe acute kidney injury (AKI) is the development of oliguria and subsequent retention of fluid. Recent studies have reported an association between fluid overload and increased mortality in critically ill patients. Achieving fluid balance control through haemofiltration is an important part of dialysis dose delivery in continuous renal replacement therapy (CRRT). AIMS: (1) Compare the prescribed dose with the delivered dose of dialysis and haemofiltration for CRRT...
June 20, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Valerie Jorge Cabrera, Anushree C Shirali
Extracorporeal modalities for the removal of drugs and toxins are indicated for the treatment of overdoses and intoxications. Well-established modalities include hemodialysis (HD), high-flux HD (HfD), and charcoal hemoperfusion (HP). Recently, there have been increasing reports on the use of continuous renal replacement therapy (CRRT), such as continuous veno-venous hemodialysis (CVVHD), continuous veno-venous hemofiltration (CVVH) or CVVH combined with dialysis (CVVHDF). In the present article, we will discuss the various factors that determine the clearance of drugs and toxins and accordingly, we will propose that with few exceptions, CRRT does not have a role in the routine management of intoxications...
July 2016: Seminars in Dialysis
Hai Yuan, Shuangqin Chen, Fengqi Hu, Qi Zhang
BACKGROUND/AIMS: The aim of this study was to explore the clinical efficacy of 2 combinations of blood purification techniques in patients with sting venom-induced multiple organ dysfunction syndrome (MODS). METHODS: A total of 23 patients received 35 sessions of hemoperfusion (HP) + continuous veno-venous hemodiafiltration (CVVHDF) treatment and 22 sessions of plasma exchange (PE) + CVVHDF treatment, respectively. RESULTS: Both HP + CVVHDF and PE + CVVHDF reduced the levels of inflammation, thus improving our patients' health condition...
2016: Blood Purification
Zied Hajjej, Hedi Gharsallah, Habiba Naija, Ilhem Boutiba, Iheb Labbene, Mustapha Ferjani
We describe a case of 58-year-old man with septic shock due to Carbapenem-resistant Klebsiella pneumoniae (CR-Kp) bloodstream infections (BSI) who was successfully treated with a high dose association of amikacin and imipenem combined with continuous venovenous hemodiafiltration (CVVHDF). A Klebsiella pneumoniae (Kp) was isolated from the catheter culture and from two blood samples, drawn from the catheter before removal and from a peripheral vein. The Kp was intermediate to Amikacin (MIC = 16 μg/ml) and was resistant to all other antibiotics including Imipenem (MIC = 4 μg/ml), Colistin (MIC = 16 μg/ml) and Tigecycline (MIC = 4 μg/ml) according to the Clinical and Laboratory Standards Institute (CLSI) published in 2011...
2016: IDCases
Derek N Bremmer, David P Nicolau, Pam Burcham, Anil Chunduri, Ganesh Shidham, Karri A Bauer
Limited data are available on ceftolozane/tazobactam dosing in patients receiving continuous renal replacement therapy (CRRT). Thus we performed a pharmacokinetic analysis of intravenous ceftolozane/tazobactam in a critically ill patient receiving CRRT at our medical center. A 47-year-old critically ill man with multidrug-resistant Pseudomonas aeruginosa pneumonia, bacteremia, and osteomyelitis was receiving ceftolozane/tazobactam 3 g (ceftolozane 2 g/tazobactam 1 g) every 8 hours while receiving continuous venovenous hemodiafiltration (CVVHDF)...
May 2016: Pharmacotherapy
Demet Demirkol, Güntülü Şık, Nilüfer Topal, Agop Çıtak, Çigdem Zeybek, Abdülhamit Tüten, Ilmay Bilge
BACKGROUND: The study aims to define the efficacy of continuous renal replacement therapy in acute metabolic decompensation treatment of maple syrup urine disease (MSUD). METHODS: All the neonates, infants and children who have had life threatening conditions due to MSUD and were treated with continuous venovenous hemodiafiltration (CVVHDF) were analyzed retrospectively. RESULTS: Fourteen patients underwent 15 sessions of CVVHDF (age range 15 days to 87 months, mean 40...
2016: Blood Purification
Noemie Besnard, Marianne Serveaux, Sonia Machado, Delphine Daubin, Vincent Brunot, Laurent Amigues, Liliane Landreau, Olivier Jonquet, Kada Klouche
AIMS: To evaluate the capability of an electrolytes-enriched solution to prevent metabolic disorders during continuous veno-venous hemodiafiltration (CVVHDF). METHODS: Serum biochemistry and clinical tolerance were compared during CVVHDF treatments with an electrolyte-enriched (Phoxilium) or standard solutions in 10 acute renal failure patients. RESULTS: As compared to standard fluids, serum potassium and phosphate levels were maintained in the normal range with Phoxilium without any supplementation but total serum calcium levels were significantly lower...
2016: Blood Purification
Daphne Eschbach, Christopher Bliemel, Ludwig Oberkircher, Rene Aigner, Juliana Hack, Benjamin Bockmann, Steffen Ruchholtz, Benjamin Buecking
PURPOSE: Incidence of geriatric fractures is increasing. Knowledge of outcome data for hip-fracture patients undergoing intensive-care unit (ICU) treatment, including invasive ventilatory management (IVM) and hemodiafiltration (CVVHDF), is sparse. METHODS: Single-center prospective observational study including 402 geriatric hip-fracture patients. Age, gender, the American Society of Anesthesiologists (ASA) classification, and the Barthel index (BI) were documented...
2016: BioMed Research International
Jody Ede, Andrea Dale
BACKGROUND: A significant problem during continuous renal replacement therapy is premature circuit failure, affecting efficacy and molecular clearance. Techniques to improve circuit failure are anticoagulation, access site and modality. A modality change was introduced, moving from continuous veno-venous haemofiltration to continuous veno-venous haemodiafiltration as a result of existing issues with failing circuit times and failure rates. AIM: The aim of this service evaluation was to ascertain if the use of continuous veno-venous haemodiafiltration compared to continuous veno-venous haemofiltration had affected failed circuit survival times and rates...
February 12, 2016: Nursing in Critical Care
Marta Ulldemolins, Ignacio Martín-Loeches, Mireia Llauradó-Serra, Javier Fernández, Sergi Vaquer, Alejandro Rodríguez, Caridad Pontes, Gonzalo Calvo, Antoni Torres, Dolors Soy
OBJECTIVES: This multicentre study aimed to describe the pharmacokinetics (PK) of piperacillin in critically ill patients with multiple organ dysfunction syndrome (MODS) receiving continuous venovenous haemodiafiltration (CVVHDF), to identify the sources of PK variability and evaluate different dosing regimens to develop recommendations based on clinical parameters. PATIENTS AND METHODS: Nineteen patients with MODS and CVVHDF receiving piperacillin/tazobactam were enrolled from three tertiary hospitals (95 plasma samples)...
June 2016: Journal of Antimicrobial Chemotherapy
Alexandre Brasseur, Maya Hites, Sandrine Roisin, Frédéric Cotton, Jean-Louis Vincent, Daniel De Backer, Frédérique Jacobs, Fabio Silvio Taccone
BACKGROUND: Infections caused by MDR Gram-negative (GN) organisms in critically ill patients are a therapeutic challenge. The administration of high-dose aminoglycoside (HDA) therapy coupled with high-flow continuous veno-venous haemodiafiltration (CVVHDF) could allow required high drug peaks to be achieved with acceptable drug elimination. METHODS: All adult patients present on the ICU between October 2009 and July 2014 who had MDR GN sepsis were considered for HDA and high-flow (>45 mL/kg/h) CVVHDF when an isolated pathogen was susceptible or had intermediate susceptibility to aminoglycosides and the patient's condition was not improving with conventional therapy...
May 2016: Journal of Antimicrobial Chemotherapy
C Roger, L Muller, S C Wallis, B Louart, G Saissi, J Lipman, J Y Lefrant, J A Roberts
OBJECTIVES: Few data are available to guide linezolid dosing during renal replacement therapy. The objective of this study was to compare the population pharmacokinetics of linezolid during continuous venovenous haemofiltration (CVVHF, 30 mL/kg/h) and continuous venovenous haemodiafiltration (CVVHDF, 15 mL/kg/h + 15 mL/kg/h). METHODS: Patients requiring linezolid 600 mg iv every 12 h and CVVHF or CVVHDF were eligible for this prospective study. Seven blood samples were collected over one dosing interval and analysed by a validated chromatographic method...
February 2016: Journal of Antimicrobial Chemotherapy
Kirsty Skinner, Ana Saiao, Ahmed Mostafa, Jessamine Soderstrom, Gregory Medley, Michael S Roberts, Geoffrey K Isbister
Isoniazid is a rare overdose that causes seizures and there is limited evidence to guide treatment. We report a 20-year-old female migrant who presented with recurrent seizures after ingesting 25 g of isoniazid. She was treated with activated charcoal, repeated doses of midazolam for the seizures, and given multiple doses of pyridoxine (14 mg), limited by availability. She was admitted to intensive care, and 5.5 hours post-ingestion, she was commenced on continuous veno-venous hemodiafiltration (CVVHDF)...
October 2015: Hemodialysis International
Weiyuan Yan, Lijie Wang
OBJECTIVE: To evaluate the clinical value of the pulse indicator continuous cardiac output (PiCCO) system in patients with severe acute pancreatitis (SAP) complicated with acute respiratory distress syndrome (ARDS). METHOD: Two cases of SAP with ARDS were monitored using PiCCO during comprehensive management in the Pediatric Intensive Care Unit (PICU) of Shengjing Hospital, China Medical University. To guide fluid management, the cardiac index (CI) was measured to assess cardiac function, the global end-diastolic volume index (GEDVI) was used to evaluate cardiac preload, and the extravascular lung water index (EVLWI) was used to evaluate the pulmonary edema...
September 2014: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Beata Marie R Quinto, Ilson J Iizuka, Julio C M Monte, Bento F Santos, Virgílio Pereira, Marcelino S Durão, Maria A Dalboni, Miguel Cendoroglo, Oscar F P Santos, Marcelo C Batista
INTRODUCTION: Critically ill patients with acute kidney injury (AKI) present high mortality rates. The magnitude of inflammatory response could determine the prognosis of such patients. Continuous renal replacement therapy (CRRT) may play an important role in removing inflammatory mediators in patients with AKI. AIM: To investigate whether the magnitude of inflammatory mediator's removal is associated with mortality among critically ill patients on CVVHDF, a CRRT modality...
February 2015: Cytokine
Julie M Varghese, Paul Jarrett, Steven C Wallis, Robert J Boots, Carl M J Kirkpatrick, Jeffrey Lipman, Jason A Roberts
OBJECTIVES: To describe the interstitial fluid (ISF) and plasma pharmacokinetics of meropenem in patients on continuous venovenous haemodiafiltration (CVVHDF). PATIENTS AND METHODS: This was a prospective observational pharmacokinetic study. Meropenem (500 mg) was administered every 8 h. CVVHDF was targeted as a 2-3 L/h exchange using a polyacrylonitrile filter with a surface area of 1.05 m2 and a blood flow rate of 200 mL/min. Serial blood (pre- and post-filter), filtrate/dialysate and ISF concentrations were measured on 2 days of treatment (Profiles A and B)...
February 2015: Journal of Antimicrobial Chemotherapy
Orhan Deniz Kara, Nida Dincel, Ipek Kaplan Bulut, Ebru Yilmaz, Kadriye Ozdemir, Gozde Gozuoğlu, Hasan Bicer, Sevgi Mir
INTRODUCTION: As intensive care units (ICU) have improved, presence of multiple-organ dysfunctions in majority of patients with acute renal failure (ARF) has become clearer. To facilitate multi-organ support, continuous renal replacement therapy (CRRT) techniques have been developed. This study is the one that reports the experience on children including newborns receiving CRRT monitored in ICU. MATERIALS AND METHODS: The study was performed retrospectively in children who had Continuous Veno- Venous Hemodiafiltration (CVVHDF) as a CRRT modality in ICU...
October 2014: Renal Failure
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