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https://www.readbyqxmd.com/read/28721515/prolonged-intermittent-renal-replacement-therapy-in-children
#1
REVIEW
Rajiv Sinha, Sidharth Kumar Sethi, Timothy Bunchman, Valentine Lobo, Rupesh Raina
Wide ranges of age and weight in pediatric patients makes renal replacement therapy (RRT) in acute kidney injury (AKI) challenging, particularly in the pediatric intensive care unit (PICU), wherein children are often hemodynamically unstable. Standard hemodialysis (HD) is difficult in this group of children and continuous veno-venous hemofiltration/dialysis (CVVH/D) has been the accepted modality in the developed world. Unfortunately, due to cost constraints, CVVH/D is often not available and peritoneal dialysis (PD) remains the common mode of RRT in resource-poor facilities...
July 18, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28708212/albumin-corrected-total-ionized-calcium-ratio-is-not-superior-to-total-ionized-calcium-ratio-as-an-indicator-of-citrate-accumulation
#2
Yin Zheng, Feng Zhuang, Qiuyu Zhu, Shuai Ma, Yao Xu, Jianxin Lu, Guihua Hao, Yong Gu, Chuanming Hao, Mingli Zhu, Feng Ding
BACKGROUND: Total/ionized calcium ratio has been used as an indirect index of increased plasma citrate concentration during citrate anticoagulation. However, they were obtained without any adjustment of total calcium for albumin. Herein, we investigated whether the albumin-corrected total/ionized calcium ratio performed better than total/ionized calcium ratio. METHODS: 20 critically ill patients were treated with continuous venovenous hemofiltration (CVVH) using citrate anticoagulation...
July 11, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28689876/impact-of-renal-replacement-modalities-on-the-clearance-of-piperacillin-tazobactam-administered-via-continuous-infusion-in-critically-ill-patients
#3
Claire Roger, Menino O Cotta, Laurent Muller, Steven C Wallis, Jeffrey Lipman, Jean-Yves Lefrant, Jason A Roberts
This prospective pharmacokinetic study aimed to compare the clearance of piperacillin-tazobactam administered as a 24-h continuous infusion between continuous venovenous haemodiafiltration (CVVHDF) and continuous venovenous haemofiltration (CVVH) applied at equal dose in critically ill patients. A loading dose of 4.5 g of piperacillin-tazobactam followed by a continuous infusion (500 mg/h) was administered to patients randomized to receive CVVHDF or CVVH. Serial pre- and postfilter blood samples were drawn during an 8-h sampling interval...
July 6, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28676904/differences-in-cvvh-vs-cvvhdf-in-the-management-of-sepsis-induced-acute-kidney-injury-in-critically-ill-patients
#4
Vedran Premuzic, Nikolina Basic-Jukic, Bojan Jelakovic, Petar Kes
We hypothesized that patients with sepsis and AKI, especially patients without preserved renal function, and treated with continuous veno-venous hemodiafiltration (CVVHDF), have lower risk for mortality than patients treated with continuous veno-venous hemofiltration (CVVH). Patients were included if they fulfilled the diagnosis of severe sepsis or septic shock, suffered AKI and received continuous renal replacement therapy (CRRT) in intensive care unit. There were 62 patients treated by CVVH and 75 treated by CVVHDF...
July 4, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28674380/exceptionally-high-creatine-kinase-ck-levels-in-multicausal-and-complicated-rhabdomyolysis-a-case-report
#5
Pavan Luckoor, Mashal Salehi, Afua Kunadu
BACKGROUND Rhabdomyolysis is a syndrome caused by muscle breakdown. It can be caused by traumatic as well as non-traumatic factors such as drugs, toxins, and infections. Although it has been initially associated with only traumatic causes, non-traumatic causes now appear to be at least 5 times more frequent. In rhabdomyolysis, the CK levels can range anywhere from 10 000 to 200 000 or even higher. The higher the CK levels, the greater will be the renal damage and associated complications. We present the case of a patient with exceptionally massive rhabdomyolysis with unusually high CK levels (nearly 1 million) caused by combined etiologic factors and complicated with acute renal failure...
July 4, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28607338/blood-purification-with-continuous-venovenous-hemofiltration-in-patients-with-sepsis-or-acute-respiratory-distress-syndrome-a-systematic-review-and-meta-analysis-of-randomized-evidence
#6
Alessandro Putzu, Ming-Xing Fang, Martina Boscolo Berto, Alessandro Belletti, Luca Cabrini, Tiziano Cassina, Giovanni Landoni
INTRODUCTION: Severe inflammatory conditions, as severe sepsis/septic shock and acute respiratory distress syndrome (ARDS), are related to high morbidity and mortality. We performed a meta-analysis of randomized trials to assess if blood purification with continuous venovenous hemofiltration (CVVH) reduces mortality in these settings. EVIDENCE ACQUISITION: Online databases were searched for pertinent studies up to March 2017. We included randomized-controlled trials on the use of CVVH as blood purification technique in comparison to conventional therapy in adult patients with severe sepsis/septic shock or ARDS but no acute kidney injury needing renal replacement therapy...
June 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28574107/continuous-renal-replacement-therapy-forty-year-anniversary
#7
Claudio Ronco
In 1977 Peter Kramer performed the first CAVH (continuous arteriovenous hemofiltration) treatment in Gottingen, Germany. CAVH soon became a reliable alternative to hemo- or peritoneal dialysis in critically ill patients. The limitations of CAVH spurred new research and the discovery of new treatments such as CVVH and CVVHD (continuous veno-venous hemofiltration and continuous veno-venous hemodialysis). The alliance with industry led to development of new specialized equipment with improved accuracy and performance in delivering continuous renal replacement therapies (CRRTs)...
May 31, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28514303/continuous-venovenous-hemofiltration-in-the-management-of-paraquat-poisoning-a-meta-analysis-of-randomized-controlled-trials
#8
REVIEW
Guodong Lin, Jianhai Long, Yuan Luo, Yongan Wang, Qiu Zewu
BACKGROUND: Paraquat (PQ) poisoning is a widespread occurrence, especially in underdeveloped areas. The treatment of PQ poisoning has always been difficult, and there is currently no definite effective treatment. Continuous venovenous hemofiltration (CVVH) treatment for PQ poisoning has been widely used in clinical practice; however, its effect remains uncertain. Accordingly, the purpose of this meta-analysis was to evaluate the efficacy of CVVH in the treatment of PQ poisoning. METHODS: We searched for relevant trials using PubMed, Embase, the Cochrane Library, and 3 Chinese databases, the Chinese BioMedical Literature Database, National Knowledge Infrastructure Database, and Wanfang Database...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28482384/-effects-and-mechanisms-of-high-volume-hemofiltration-on-endotoxin-induced-acute-lung-injury-of-piglets
#9
W M Chen, G F Yan, Z J Lu, G P Lu
Objective: To compare the effects of high-volume hemofiltration (HVHF) and continuous veno-venous hemofiltration (CVVH) on cardiopulmonary functions, lung fluid balance, lung damage and cytokine expression in endotoxin-induced acute lung injury piglet model, and to further evaluate the value of high-volume hemofiltration in acute lung injury. Method: Eighteen piglets were randomly divided into the control group (6 piglets), the CVVH group (6 piglets) and the HVHF group (6 piglets). By general anesthesia, the intravenous infusion of 0...
May 4, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28481454/severe-acute-valproic-acid-intoxication-successfully-treated-with-liver-support-therapy
#10
Yongchun Ge, Bin Xu, Chuan Li, Qunpeng He, Tingting Zhu, Rong Fan, Dehua Gong
Valproic acid (VPA) is widely used for treatment of epilepsy. However, its overdose can cause intoxication and could be life-threatening. Due to lack of specific antidote and poorness of endogenous clearance, extracorporeal treatment for severe intoxication cases is indicated. Here, we report a case of severe intoxication of VPA which was successfully treated with liver support therapy. A previously healthy woman was admitted due to coma and hypotension after intentional ingestion of 20 g of sodium valproate...
May 8, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28468893/continuous-renal-replacement-therapy-a-potential-source-of-calories-in-the-critically-ill
#11
Andrea M New, Erin M Nystrom, Erin Frazee, John J Dillon, Kianoush B Kashani, John M Miles
Background: Overfeeding can lead to multiple metabolic and clinical complications and has been associated with increased mortality in the critically ill. Continuous venovenous hemofiltration (CVVH) represents a potential source of calories that is poorly recognized and may contribute to overfeeding complications.Objective: We aimed to quantify the systemic caloric contribution of acid-citrate-dextrose regional anticoagulation and dextrose-containing replacement fluids in the CVVH circuit.Design: This was a prospective study in 10 critically ill adult patients who received CVVH from April 2014 to June 2014...
June 2017: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28446744/levetiracetam-pharmacokinetics-in-a-patient-with-intracranial-hemorrhage-undergoing-continuous-veno-venous-hemofiltration
#12
Edward T Van Matre, Scott W Mueller, Douglas N Fish, Robert MacLaren, Luis F Cava, Robert T Neumann, Tyree H Kiser
BACKGROUND Levetiracetam is an antiepileptic drug frequently used in critically ill patients. Levetiracetam is primarily eliminated as a parent compound via glomerular filtration and requires dose adjustment in renal insufficiency, but the literature on patients receiving continuous veno-venous hemofiltration (CVVH) is scant. CASE REPORT We report the levetiracetam pharmacokinetic profile of a patient being treated with levetiracetam 1000 mg intravenously every 12 h who required continuous veno-venous hemofiltration (CVVH)...
April 27, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28416553/pharmacokinetics-and-dialytic-clearance-of-ceftazidime-avibactam-in-a-critically-ill-patient-on-continuous-venovenous-hemofiltration
#13
Eric Wenzler, Kristen L Bunnell, Susan C Bleasdale, Scott Benken, Larry H Danziger, Keith A Rodvold
Ceftazidime-avibactam administered at 1.25 g every 8 h was used to treat multidrug-resistant Pseudomonas aeruginosa bacteremia in a critically ill patient on continuous venovenous hemofiltration (CVVH). Prefiltration plasma drug concentrations of ceftazidime and avibactam were measured at 0, 1, 2, 4, 6, and 8 h along with postfiltration and ultrafiltrate concentrations at h 2 and h 6. Plasma pharmacokinetic parameters of ceftazidime and avibactam, respectively, were as follows: maximum plasma concentration (Cmax), 61...
July 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28409035/the-use-of-coupled-plasma-filtration-adsorption-in-traumatic-rhabdomyolysis
#14
Mario Pezzi, Silvia Renda, Anna Maria Giglio, Anna Maria Scozzafava, Simona Paola Tiburzi, Patrizia Casella, Fabrizio Iannelli, Mario Verre
Severe musculoskeletal injuries induce the release of sarcoplasmic elements such as muscle enzymes, potassium, and myoglobin in the systemic circulation. The circulating myoglobin damages the glomerulus and renal tubules. Conventional haemodialysis is not able to remove myoglobin, due to its high molecular weight (17,8 kilodaltons [kDa]). We treated four traumatic rhabdomyolysis patients with Coupled Plasma Filtration Adsorption (CPFA) in order to remove myoglobin followed by 14 hours of Continuous Veno-Venous Hemofiltration (CVVH)...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28403554/continuous-veno-venous-hemofiltration-improves-survival-of-patients-with-congestive-heart-failure-and-cardiorenal-syndrome-compared-to-slow-continuous-ultrafiltration
#15
Vedran Premuzic, Nikolina Basic-Jukic, Bojan Jelakovic, Petar Kes
Continuous veno-venous hemofiltration (CVVH) could modulate the inflammatory response by removal of circulating cytokines and therefore improve cardiac function in patients with heart failure (HF). We hypothesized that patients with developed cardiorenal syndrome and treated with CVVH have lower risk for mortality than other patients treated with slow continuous ultrafiltration (SCUF). This was a prospective, longitudinal follow-up study for 24 months duration. In total, 120 patients were recruited from the intensive care units...
June 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28372501/hyperlactatemia-predicts-citrate-intolerance-with-regional-citrate-anticoagulation-during-continuous-renal-replacement-therapy
#16
Jia-Neng Tan, Sabrina Wong Peixin Haroon, Amartya Mukhopadhyay, Titus Lau, Tanusya M Murali, Jason Phua, Zong-Yao Tan, Nicholas Lee, Horng-Ruey Chua
PURPOSE: We aim to determine whether hyperlactatemia, which suggests multi-organ dysfunction and impaired organic substrate metabolism, may predict intolerance to regional citrate anticoagulation (RCA) during continuous venovenous hemofiltration (CVVH). METHODS: We performed a single-center, retrospective observational study in critically ill patients with acute kidney injury or end-stage renal disease and evaluated the association of peak serum lactate levels with citrate intolerance (CI) during the initial 72 hours of RCA-CVVH, defined by serum total-to-ionized calcium >2...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28219324/non-anti-coagulant-factors-associated-with-filter-life-in-continuous-renal-replacement-therapy-crrt-a-systematic-review-and-meta-analysis
#17
Matthew Brain, Elizabeth Winson, Owen Roodenburg, John McNeil
BACKGROUND: Optimising filter life and performance efficiency in continuous renal replacement therapy has been a focus of considerable recent research. Larger high quality studies have predominantly focussed on optimal anticoagulation however CRRT is complex and filter life is also affected by vascular access, circuit and management factors. We performed a systematic search of the literature to identify and quantify the effect of vascular access, circuit and patient factors that affect filter life and presented the results as a meta-analysis...
February 20, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28217064/a-simple-technique-to-achieve-vascular-access-for-continuous-venous-venous-ultrafiltration-in-a-toddler
#18
Joseph Drew Tobias
Acute renal failure is associated with increased mortality in the Pediatric Intensive Care Unit. When anuric or oliguric renal failure occurs, the associated fluid overload may compromise respiratory function and has been shown to be associated with worse outcomes. Renal replacement therapy using continuous venous-venous hemofiltration (CVVH) allows for fluid, solute, and nitrogenous waste removal. However, large bore vascular access with placement of a double-lumen dialysis catheter is necessary to ensure effective flow rates to allow for CVVH...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28197045/experiences-with-continuous-venovenous-hemofiltration-using-18mmol-l-predilution-citrate-anticoagulation-and-a-phosphate-containing-replacement-solution
#19
Yuen Henry Jeffrey, Shum Hoi-Ping, Anne Leung Kit Hung, Lam Chung-Ling, Yan Wing-Wa, Lai King-Yiu
CONTEXT: Regional citrate anticoagulation for continuous renal replacement therapy is associated with a longer filter-life, less bleeding events and improved mortality. Problems associated with using Prismocitrate 10/2 solution in continuous renal replacement therapy, include hypomagnesemia, hypophosphatemia and the need for additional bicarbonate infusion. AIMS: This study uses the new Prismocitrate 18/0 solution for improved buffer balance and Phoxilium solution for a more favourable electrolyte profile...
January 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28124668/treatment-of-cefuroxime-induced-neurotoxicity-with-continuous-venovenous-haemofiltration
#20
D G H A van Dam, D M T Burgers, N Foudraine, P K C Janssen, C Neef, J L M L le Noble
A 61-year-old woman with decreased consciousness, myoclonus, tremors, nystagmus and bradypnoea, due to cefuroxime-induced neurotoxicity, was admitted to the intensive care unit. Continuous venovenous haemofiltration (CVVH) rapidly reduced plasma cefuroxime concentrations and improved neurological manifestations within the next few hours. Retrospective pharmacokinetic assessment showed a total cefuroxime clearance of 166 ml/min during the CVVH.
January 2017: Netherlands Journal of Medicine
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