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

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<strong>ABSTRACTS</strong> FROM 17 TH INTERNATIONAL CONFERENCE ON CRRT, SAN DIEGO, FEB 14-17, 2012 liver, 51.6% (31/60) for heart and 40.9% (9/22) for lung graft recipients, respectively. Mean serum creatinine at the end of the study period (30 days) was 2.34 mg% (1,97 mg% in liver, 2,26 mg% in heart and 2,89 mg% in lung graft recipients, respectively). Our 10-year retrospective analysis revealed an increased incidence of AKI in the NRSOT population. The main cause of AKI was sepsis which was associated with an increase of mortality and with an impairment of renal function that may be responsible for the progression toward CKD. 50. Case Report of Renal Replacement Therapy in a 1-year old patient with AKI Gastón Castillo, Magda Cepeda, Jaime Restrepo Fundación Valle del Lili Renal replacement therapy in children is a rare event, but with important implications for morbidity and mortality in this age group. Although the incidence of children with kidney failure is relatively low and patients requiring renal replacement therapy are usually few in these, has been recognized the significant positive impact on early recognition of children who require and implement of adequate therapy. According to the annual report of the UK Renal Registry, during 2009 there were 751 children with established renal injury receiving renal replacement therapy. We report a case of a patient who required renal replacement therapy secondary to a procedure-related multiorgan failure. The patient was referred <strong>from</strong> a peripheral center of care with a diagnosis of septic shock of abdominal origin, multiorgan failure, acute renal injury, post- laparotomy for correction of intestinal mal-rotation, intestinal obstruction and release of congenital constricting bands and syndrome postresuscitation. The patient was hospitalized in the Pediatric Intensive Care Unit (PICU). The principal clinical of the patient consisted in 6 days of intestinal obstruction, secondary to constricting bands and intestinal malrotation. In the course of corrective surgery, the patient presented cardiorespiratory failure accompanied by renal failure, and was referred to institution. To acute renal injury management we used renal replacement therapy with continuous veno-venous hemofiltration (CVVHF) for five days, then started continuous infusion of furosemide in which there was no improvement, which required restarting CVVHF for 18 days and hemodiafiltration with pump flow to 100ml/min with fluid loss of 150 ml/h. Renal function recovery was obtained after 30-days of management. As a related complication, blow up of catheter and filter plugging occurred. After a 30-days hospitalization, the patient was discharged with additional diagnosis of postoperative of severe pneumonia and acute respiratory distress syndrome, septic shock refractory to inotropic fungemia resolved, myocardial dysfunction, renal dysfunction and acute renal injury. Acute renal injury is a condition that quickly complicated pediatric patient, sepsis remains the leading cause of the complication reported in multiple series. Previous reports have shown the advantage of starting early RRT patients with a significant favorable impact in patients with sepsis and multi-organic failure. 161
<strong>ABSTRACTS</strong> FROM 17 TH INTERNATIONAL CONFERENCE ON CRRT, SAN DIEGO, FEB 14-17, 2012 51. Survival and Mortality Risk Factors in Mexican Patients with Acute Kidney Injury Luis A Evangelista-Carrillo, Miguel Beltrán, Salvador Mendoza, Jorge Andrade-Sierra, Enrique Rojas-Campos, Alfonso Cueto-Manzno, Benjamín Gómez-Navarro Department of Nephrology and Transplantation, Hospital de Especialidades, CMNO, IMSS, Guadalajara, Jalisco, Mexico , Medical Research Unit in Renal Disease, CMNO, IMSS, Guadalajara, Jalisco, Mexico Background: Acute Kidney Injury (AKI) information is scarce in Latin American ICU and non ICU patients. Aim: To determine patient survival, mortality risk factors and treatment in AKI patients <strong>from</strong> a hospital of the West of Mexico. Methods: Prospective cohort (Jan-May2011) of 79 patients with AKI (AKIN classification), diagnosed and treated by Nephrologists, were recorded at admission, at AKI diagnosis and daily for 1 month: age, gender, time between AKI onset and Nephrology diagnosis, fluid balance, SOFA, APACHE II, ISI, treatment (IHD, CCRT, conservative),date of death or patient discharge and other clinical and biochemical variables. Results: Mean age was 52±18 years, 61% were male, 48% were <strong>from</strong> ICU, 50% had surgery, 25% had sepsis; 59% had AKIN 3, mean time between AKI onset and Nephrology consultation was 59±48 hours, 56% received conservative treatment, 28% IHD and 16% CCRT; mean hospitalization was 15±9 days; Mortality was 51% (according to treatment was 46% conservative, 41% IHD and 92% CCRT) Results are shown in Table 1 (Comparisons according to hospitalization site and mortality). Mortality predictors at day of diagnosis were: Δ SCr, Uresis volume and diuretic use (χ2=11.4; p=0.01); and predictors 24-Hrs after were: Diuretic use and SOFA score (χ2=7.1; p=0.03) Conclusions: Mortality was similar to other studies, was high in general ward (42%)and was significantly predicted at diagnosis by small changes in serum creatinine. At 24 hours evaluation, SOFA and conservative treatment significantly also predict mortality. Fluid balance(Lt) ICU ( n=30) 6.7 (3.3- 11.3) General ward (n=49) p< 0.05 3.1 (0.8-6.4) SCr Δ 1.8±1.5 3.6±3.1 Mortality n(%) 20(67) 20(42) Fluid balance(Lt) Alive (n=39) 2.08 (-0.38- 5.4) SCr Δ 3.7±3.2 2±1.8 SOFA (pts) 10±3 13±3 Diuretic use N (%) Dead (n=40) p< 0.05 6.8 (3.3-11.4) 21 (70) 19 (40) ISI ( pts) 0.37±0.2 0.57±0.3 52. The Impact Of The Daily Presence Of The Nephrology Resident In The Postoperative Cardiac Intensive Care Unit César Flores-Gama, Armando Vázquez- Rangel, Maribel Merino-López, Francisco Baranda-Tovar, Israel Campos-González Instituto Nacional de Cardiología Ingnacio Chávez Background: Acute kidney injury (AKI) is a significant cause of morbidity and mortality following cardiac surgery. 162
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CRRT 2012 SEVENTEENTH INTERNATIONAL
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FACULTY DISCLOSURES CRRT 2012 Facul
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CRRT 2012 ORGANIZING COMMITTEE USA
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CRRT 2012 FACULTY Patrick Honoré,
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ACKNOWLEDGEMENTS CRRT 2012 ACKNOWLE
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PLENARY SESSIONS CRRT 2012 PROGRAM/
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WORKSHOPS CRRT 2012 PROGRAM/INDEX T
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WORKSHOPS CRRT 2012 PROGRAM/INDEX W
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POSTER ABSTRACTS C
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POSTER ABSTRACTS C
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NURSING FORUM LUNCHEON Communicatio
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Nutritional Support in ICU Patients
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Educational Objectives: The Endothe
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SPECIAL LECTURE Engineering Critica
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Nishimura R, Ornato JP, Page RL, Ri
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Do Vasoactive Drugs and Fluids Impr
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Blood Transfusions are Important fo
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Thinking Outside of the Box: A Nove
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Nursing Forum 2 Luncheon Benchmarki
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4. Mori K, Lee HT, Rapoport D, Drex
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Differential Diagnosis of AKI: Can
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Myocardial Stunning and Brain Edema
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4. Udy A, Roberts JA, Lipman J. Wha
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CRRT and ECMO: Techniques and Outco
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Management of Severe Heart Failure:
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Avoiding Anticoagulation for CRRT:
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Improving Outcomes from</st
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The Changing Face of AKI: Snapshots
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Alkaline Phosphatase Peter Pickkers
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creatinine (Cr) was measured using
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Surveillance and Early Recognition
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therapy admitted to general intensi
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A01 Assessing the Microcirculation
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A01 Assessing the Microcirculation
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C03 Critical Care Pharmacology: Vas
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D04 Biomarkers 1: Principles and Ap
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6. Ferguson JW, Dover AR, Chia S, C
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G07 Fluids and Solutions in the Cri
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A09 Vascular Access /Membrane and C
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A09 Vascular Access /Membrane and C
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C11 Critical Care Management: Nutri
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D12 Biomarkers 2: Application in AK
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Educational Objectives: E13 Liver a
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G15 Fluids and Solutions in the Cri
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Educational Objectives: 1) Discuss
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B18 Fluid Management Ravindra L. Me
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C19 Acid Base and Electrolyte Probl
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D20 Extracorporeal Techniques for S
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the mediatordelivery hypothesis. In
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F22 Ensuring Patient Safety and Qua
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H24 Patient Centered Care in the IC
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B26 Starting and Stopping RRT for A
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C27 Acid Base and Electrolyte Probl
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