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

<strong>ABSTRACTS</strong> FROM 17 TH INTERNATIONAL CONFERENCE ON CRRT,
SAN DIEGO, FEB 14-17, 2012
clinically.
Results- We studied 255 CRRT systems
in 69 patients. There were 43 males, 26
females and average age was 57 ± 12
yrs. Average filter life for group 1 was
18.7 ± 13.7 hrs and for group 2 it was
25. ± 15.4hrs (p-value adjusted for
clustering = .4). We then analyzed those
with reported clotting as reason for
system discontinuation (n=15) and noted
a significant difference in filter patency.
Average filter life for group 1 was14.3±
9.5 hrs and for group 2 it was 18.7 ± 1.5
hrs. (p-value adjusted for clustering =
.1). Conclusion: Contrary to
conventional teaching, our results show
that average filter life was longer in
those patients on CVVHD as compared
to pre-dilution CVVH. We conclude that
Pre filter CVVH may be associated with
more clotting as compared to CVVHD
and while choosing a system for a
patient with a contraindication for
anticoagulation this factor should be
taken into consideration.
60. Saturation Coefficient Estimate of
Peramivir in a Patient Receiving
Continuous Veno-Venous
Hemodiafiltration
Michael L Bentley, Amanda C Hansen,
Jean A Smith, James S Cain
Department of Pharmacy, Carilion
Roanoke Memorial Hospital (CRMH)
and Virginia Tech Carilion School of
Medicine (VTCSOM), Department of
Pharmacy, CRMH and VTCSOM,
Department of Medicine, Section of
Infectious Disease, CRMH and
VTCSOM, Valley Nephrology Associates
and VTCSOM
Purpose: To estimate the saturation
coefficient of peramivir in a patient
receiving continuous veno-venous
hemodiafiltration (CVVHDF) during the
Fall of 29. Peramivir is a potent
neuraminidase inhibitor having activity
against various influenza A and B
subtypes. The main route of elimination
is the kidney and a dose reduction is
justified when the creatinine clearance is
< 5 ml/min. Information <strong>from</strong> the
manufacturer regarding dosing during
continuous renal replacement therapy
(CRRT) did not exist at the time of this
analysis. A 29-year-old female with a
history of flu like symptoms presented to
a local emergency department. To
manage volume and provide
extracorporeal renal support CVVHDF
was initiated. An infectious disease
consult was obtained to evaluate the
patient for emergency use peramivir and
assist in the management of
Streptococcus pneumoniae pneumonia
and bacteremia. An initial peramivir
dose of 6 mg followed by 48 mg every
24-hours was administered
intravenously. This dose was derived
based on current CRRT settings and an
estimated saturation coefficient (SA) of
Methods: CVVHDF was performed
using a Prisma pump and an AN69 filter.
During peramivir sampling, blood flow
was maintained at 1 ml/minute with a
dialysate flow rate of 16.7 ml/minute
and a convective rate, using pre-filter
solution, of 8.3 ml/minute, respectively.
The mean total ultrafiltrate produced
during sampling was 14.2 ml/minute. To
calculate a saturation coefficient (SA),
sampling of blood and effluent were
conducted. Pre- and post-filter as well as
an effluent sample were obtained 4- and
8-hours following the third dose of 48
mg. Results: Using an estimated SA of
1, a dose of 48 mg (following a 6 mg
load) was given every 24-hours. Serum
levels were obtained as described and
analyzed. A linear decrease was
observed over a 24-hour period (graph)
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