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

<strong>ABSTRACTS</strong> FROM 17 TH INTERNATIONAL CONFERENCE ON CRRT,
SAN DIEGO, FEB 14-17, 2012
of pH and subvisible particles. Dogs
were euthanized and lung tissue samples
were examined histologically. Results:
All CV parameters remained stable and
no differences were observed between
the test and negative control articles.
Sephadex beads caused an increase
(p.5) in PCO2. No differences in lung
histology were observed between the test
and negative control articles. The lungs
<strong>from</strong> all dogs given Sephadex beads
contained multiple intravascular
particles in large caliber blood vessels.
Conclusion: CVVH performed on
anesthetized dogs for 6 hr using Accusol
35 containing visible and sub-visible
particles 36X higher than the maximum
concentration specified in EP, resulted in
no adverse effects on CV parameters,
blood gases, and lung histology as
compared with Accusol 35 containing no
visible particles and sub-visible particles
that were within EP specification.
17. Carboplasmapheresis and
Continuous Renal Replacement
Therapy (CRRT) in the Treatment
of Amanita Phalloides Poisoning
Roumen 1 Penkov, Spasena Hristova,
Pavel Angelov
Military Medical Academy
Introduction: Amanita phalloides
poisoning is the most common cause of
lethal mushroom poisoning (lethality >
2% in adults and > 4% in children).
Carbohaemoperfusion is a routine
treatment in mushroom poisoning for
many years already. We have applied
carboplasmaperfusion (CPP), aiming at
extracting the aminitine toxins <strong>from</strong>
patient’s plasma. We have performed
continuous vein-venous high flux
haemodiafiltration (CVVHDF) for the
sake of prevention <strong>from</strong> hepatic and
renal failure. Methods: We have carried
out an early carboplasmapheresis in four
patients with amanita phalloides
intoxication, which poisoning has been
proven by clinical and toxico-chemical
tests. In addition to carboplasmapheresis
we have carried out CVVHDF for 12
hours per day. We have performed the
procedures via a system for continuous
renal replacement therapy (CRRT). We
have performed plasma separation via
plasma filter Haemoselect M ,3, and
subsequently plasma has been conducted
via carbofilter ADSORBA 3 C. We have
utilized the same system and high flux
Diacap Acute filters for the performance
of CVVHDF. Results: Upon the first
course of carboplasmapheresis, there has
been observed clinical and laboratory
detoxication in two of our patients and
no hepatic failure observed. Two more
CVVHDF procedures have added to the
favorable outcome. There has been
observed an early hepatic failure in the
other two patients, so we had to apply
three more carboplasmapheresis and
CRRT therapies. The patients have been
released <strong>from</strong> the hospital at the 7th or
18th day, following clinical remission.
Upon control monitoring at first month
after release <strong>from</strong> hospital, those two
patients with early hepatic failure have
proven to be clinically healthy and the
results <strong>from</strong> their laboratory tests to be
within the reference range.
Conclusions: Carboplasmapheresis
treatment in cases of mushroom
poisoning is a modern therapy, which
several studies report to be successful
when applied in clinical practice. This
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