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

<strong>ABSTRACTS</strong> FROM 17 TH INTERNATIONAL CONFERENCE ON CRRT,
SAN DIEGO, FEB 14-17, 2012
consecutively over 8 months to the
Renal Service. Conventional “absolute”
indications for dialysis were: serum K
≥6. µmol/L, serum urea ≥3 mmol/L,
arterial pH ≤7.15, serum HCO3 ≤1
mmol, acute pulmonary edema, acute
uremic encephalopathy and/or
pericarditis (Group 2). In their absence,
ARRT was initiated at (i) AKIN Stage 3
and (ii) AKIN Stage 1 or 2 with
additional hypercatabolic indications
(Group 1). Results: Thirty-four critically
ill patients were studied (mean age 61±3
years, M:F=22:12, MICU: SICU 21:13,
mean APACHE II score 25±1, mean
SOFA score 12±1) with mean premorbid
serum creatinine 16±11 µmol/L. Main
AKI causes were sepsis (n=35) and
ischemia (n=14). Baseline demographic
and clinical characteristics were
comparable in Group 1 (n=14) vs. Group
2 (n= 2), including peak serum
creatinine (µmol/L) (at referral) 296±41
vs. 394±51, p=.26. Overall ICU
mortality was 47%. Comparing Group 1
vs. 2, mean CRRT effluent flow
(ml/kg/h) 33.3±3.6 vs. 31.9±2.1, p=.95;
ICU mortality 43% vs. 5%, p = .68; inhospital
mortality 57% vs 65%, p=.64;
and, renal recovery at 28 days 43% vs.
25%, p = .32. Conclusion: Use of
modified AKIN criteria to effect earlier
ARRT initiation did not improve clinical
outcomes in ICU patients with high
APACHE II scores. Further large scale
studies are needed to clarify the role of
earlier ARRT initiation.
43. Formation of the Kidney
Intervention During
Extracorporeal Membrane
Oxygenation (KIDMO) pediatric
study group
David T Selewski, David J Askenazi,
Brian C Bridges, David Cooper,
Matthew L Paden, Michael Zappitelli,
Geoffrey M Fleming
Division of Pediatric Nephrology,
University of Michigan School of
Medicine, Ann Arbor, Michigan, USA ,
Division of Pediatric Nephrology,
University of Alabama Birmingham,
Birmingham, Alabama, USA , Division
of Pediatric Critical Care, Vanderbilt
University School of Medicine,
Nashville, Tennessee , USA , The Heart
Institute, Division of Cardiology,
Cincinnati Children's Hospital,
Cincinnati, Ohio, USA , Division of
Pediatric Critical Care, Emory
University, Atlanta, Georgia, USA ,
Division of Pediatric Nephrology,
McGill University Health Centre,
Montreal, Canada
Background: Extracorporeal membrane
oxygenation (ECMO) is a life-saving
therapy for pediatric and adult patients
with severe cardiac and/ or respiratory
failure. ECMO patients are at increased
risk of acute kidney injury (AKI) and
development of fluid overload (FO),
which are associated with increased
mortality. Many of these patients receive
renal support therapy (RST). However,
the RST-ECMO literature consists only
of single center experiences with often
insufficient patient enrollment. A need
exists for a multi-center group to
evaluate AKI and RST on ECMO in a
comprehensive, prospective manner.
Objective: To form a multi-center study
group to allow for the efficient study of
AKI, FO, and RST in pediatric ECMO
patients. Methods: A multi-disciplinary
team of pediatric critical care,
cardiology, nephrology, and ECMO
experts was assembled <strong>from</strong> multiple
large children’s hospitals.
155