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

<strong>ABSTRACTS</strong> FROM 17 TH INTERNATIONAL CONFERENCE ON CRRT,
SAN DIEGO, FEB 14-17, 2012
were utilized for copper clearance.
Blood Copper, Haptoglobin, and
Ceruloplasmin levels were monitored
before and after each treatment.
Results: Treatments alternated between
MARS and plasmapheresis. MARS
sessions consisted of 8 hours of albumin
dialysis each followed by CVVHDF.
Plasmapheresis sessions replaced 1.2
times the plasma volume with fresh
frozen plasma. Copper reduction ratios
for each modality are shown in the table.
Hemolytic anemia did not improve until
after 3 total treatment sessions (2 MARS
and 1 plasmapheresis). The patient was
bridged to liver transplantation following
a total of 5 sessions ( 3 MARS and 2
plasmapheresis). In this case, average
copper reduction ratios were MARS vs.
plasmapharesis were similar (18.6% vs.
26.9%, p=.5). Conclusion: Both MARS
and Plasmapheresis can be used to for
copper clearance in Wilson’s crisis. Side
effects of FFP replacement in
plasmapheresis are not seen with MARS.
Either modality can be used as a bridge
to liver transplant.
Copper
pretherapy
(mcg/dL )
Copper
posttherapy
Copper
Reduction
Ratio
1st
M
2nd
M
3rd
M
1st
PP
2nd
PP
183 115 86 154 81
154 85 74 115 58
15.8
%
26.1
%
13.9
%
25.3
%
28.3
%
14. Comparison of Electrolyte
Replacements with and without
Prismasol® Replacement Fluid
Kari Mount, Samir Parikh, Ganesh
Shidham
The Ohio State University Medical
Center
Purpose: Prismasol® premade
replacement fluid is more physiologic
containing potassium, magnesium, and
calcium as compared with pharmacycompounded
sodium chloride
replacement fluid (standard therapy).
The purpose of this study was to
evaluate electrolyte replacement needs
comparing Prismasol® and standard
therapy. Methods: This study was
performed at The Ohio State University
Medical Center <strong>from</strong> August 21-
February 211. Data was prospectively
collected and matched with historical
controls. Patients receiving standard
therapy prior to implementation of
Prismasol® were case-matched to the
first 26 Prismasol® patients. Patients
were only given Prismasol® for a
maximum of 7 days due to limited
supply of the product during the pilot.
All continuous renal replacement
therapy (CRRT) patients at our
institution have standardized electrolyte
replacement protocols for potassium (K),
magnesium (Mg), calcium (Ca), and
phosphorus (Phos). The number
electrolyte replacements given was
collected during both Prismasol® and
standard therapy. Each replacement was
defined as follows: potassium chloride
4mEq, magnesium sulfate 2 grams,
calcium chloride 2 grams, sodium
phosphate 15 mmol. The number of
times the physician wrote orders to
change the replacement fluid was also
collected. Results: There were 26
patients in each group (11 cardiothoracic
surgery and 15 <strong>from</strong> the medical
intensive care unit). The CRRT duration
for Prismasol® was a mean of 84.8
hours compared to 15.9 hours with
standard therapy. Of the Prismasol®
patients, 14 received a product with 2
132