ABSTRACTS from 16th International COnference on ... - CRRT Online

<strong>ABSTRACTS</strong> FROM 17 TH INTERNATIONAL CONFERENCE ON CRRT,
SAN DIEGO, FEB 14-17, 2012
vasoactive drugs, number of organ
failures, ultrafiltration rate and arterial
pH. Conclusion: The survival rates of
non-ESRD and ESRD patients requiring
CRRT did not differ, and conventional
HD may be not a significant predictor of
mortality.
Age, years
Admission to
CRRT, day
APACHE II
score
Medical
setting (%)
No. of organ
failure
Serum BUN
(mg/dL)
Serum
creatinine
(mg/dL)
Leukocyte (×
13/μL)
Hemoglobin
(g/dL)
Platelet (×
13/μL)
Serum
albumin (g/dL)
UFR
(mL/kg/hr)
ESRD
(n=24)
53.6 ±
31.6
6.4 ±
8.5
89.2 ±
34.9
Non-
ESRD
(n=76)
49.5 ±
28.2
8.4 ±
28.7
89. ±
32.5
P
value
.324
.819
.982
2 (83.3) 54 (71.1) .293
1.4 ± .8 1.8 ± .9 .131
59.2 ±
33.9
53.2 ±
28.5
6.5 ± 4. 3.5 ± 2.3 .2
12.6 ±
5.1
1.3 ±
1.7
126.2 ±
5.5
14.6 ±
1.2
.391
.351
1.4 ± 2.1 .71
15.6 ±
82.2
.534
2.5 ± .6 2.7 ± .5 .179
22.4 ±
4.6
21.7 ±
4.4
.69
Sepsis (%) 12 (5) 48 (63.2) .251
Cardiac
dysfunction 14 (57) 3 (38) .91
(%)
Death (%) 1 (41.7) 43 (56.6) .22
8. Correction of Severe
Hypernatremia With Continuous
Renal Replacement Therapy Using
Regional Citrate Anticoagulation
Bethany Karl, Eileen Lischer, Amber P
Sanchez
University of California San Diego
A 27 years old pregnant woman with
systemic lupus erythematosis was
admitted at 33 weeks gestation with
chest pain, headache, and vomiting and
diagnosed with eclampsia. Her
neurologic status deteriorated rapidly
and an emergent cesarean section was
performed. Imaging revealed a large leftsided
intra-parenchymal hemorrhage
with mass effect and she returned to the
OR for evacuation where a large
ruptured arterio-venous malformation
was discovered. For neurologic
protection, hypertonic saline was
intermittently administered to keep the
serum sodium 155-16mmol/L.
Creatinine was .9mg/dL on admission
and rose to 2.57 by hospital day 7. As
her renal function declined, she was less
able to regulate her sodium balance and
the serum sodium rose to 18’s by
hospital day 13 and was refractory to
hypotonic fluids. In order to bring the
serum sodium down in a controlled
fashion, continuous renal replacement
therapy (CRRT) was initiated on day 16
with regional citrate for anticoagulation
(RCA). Initial dialysate was custommade
to contain a sodium concentration
of 147meq/L (versus the standard
sodium concentration of 117meq/L).
Trisodium citrate was kept at a constant
rate of 15 ml/hour to avoid variability in
sodium delivery. After 2 hours, the
sodium had decreased <strong>from</strong> 18 to 176.
At 3 hours, the sodium dropped to 173
and the replacement solutions were
modified to contain a sodium
concentration of 174meq/L (Normal
127