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

<strong>ABSTRACTS</strong> FROM 17 TH INTERNATIONAL CONFERENCE ON CRRT,
SAN DIEGO, FEB 14-17, 2012
ventilation rate was 73.2%, vasoactive
drug was 63.8%. The average SAPS3
was 78.4 ± 15.9 and the average
APACHE II score was 26.5 ± 4.3. The
variables influencing mortality on
univariate analysis were SAPS3 and
BNP, the number of organ dysfunction.
Conclusion: Very important prognostic
factors were SAPS3 and the elevation of
BNP in this study. Large scaled,
prospective randomized multi-center
trials are needed to confirm the
prognostic factor.
26. Citrate in a Small Intensive Care
Unit (ICU) in the Netherlands;
The Better Way for Dialysis?
Els L Van Assche 1
Elkerliek Ziekenhuis
Background: Renal replacement
therapy (RRT) is performed in order to
prevent and treat complications of acute
kidney injury. Small ICU’s are
challenged to optimize the procedures.
Since regional citrate anticoagulation is
proven an effective and safe method for
continuous RRT, we replaced the
heparin protocol and introduced citrate
as the new anticoagulants. Methods: We
conducted a retrospective observational
study to compare the citrate and heparin
protocol. We studied mortality, filter
survival time, transfusion of packed cells
(PC) frequency and other complications
during dialysis. We reviewed the
medical records of the 63 patients who
had continuous RRT <strong>from</strong> January 27
until September 211. We used our
patient data management system to
compare the data <strong>from</strong> the citrate group
to the data <strong>from</strong> the heparin group. 18
patients were excluded with insufficient
data and 22 filters which were
interrupted intentionally were also
excluded. Results: A total of 45 patients
were included in this study, 21 in the
heparin group and 24 in the citrate
group. In the patients who received
heparin, 112 filters were used, with a
mean of 5 filters per patient and median
filter time of 13 hours. In patients who
received citrate, 66 filters were used,
with a mean of 4 filters per patient and
median filter time of 56 hours.
In the heparin group 86 transfusions
were needed in 18 patients, 7 patients
needed more than 2 PC during dialysis
treatment. In the citrate group 26
transfusions were given to 11 patients; 3
patients needed more than 2
transfusions. Only the heparin protocol
was interrupted, 8 times, for
complications. The mortality in the ICU
was worse in the citrate group; 54%
compared to 26 % in the heparin group.
Conclusions: Although mortality was
higher in the citrate group, we found no
complications so we consider citrate a
safe anticoagulans for RRT. The higher
mortality can be explained by the higher
Apache scores. The median filter time
proves citrate to be superior to heparin.
27. Ultrafiltration in Continuous
Renal Replacement Therapy: Is
Prescribed Delivered ?
William E Weber, Sagar S Patel, Nand K
Wadhwa
Stony Brook University, Stony Brook, NY
Background: Hypervolemia <strong>from</strong>
aggressive fluid resuscitation in critically
ill patients with acute kidney injury
(AKI) may contribute to adverse
outcomes. Continuous renal replacement
therapy (CRRT) can effectively achieve
fluid management goals in
hemodynamically unstable patients with
AKI. Methods: We collected data on
physician prescription orders compared
to actual delivered treatments to assess
the delivered CRRT therapy in critically
ill patients with AKI. 18 patients (mean
age 53 + 17 years (SD); 12 males, 6
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