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

<strong>ABSTRACTS</strong> FROM 17 TH INTERNATIONAL CONFERENCE ON CRRT,
SAN DIEGO, FEB 14-17, 2012
Fr diameter. Anticoagulation was
achieved with heparin. CVVHDF
durations were 8, 3, 6, 2 and 5 days. No
hemodynamic or technical issue
occurred during the CVVHDF courses.
Normalization of electrolyte balance was
reached within the first 24 hours of
CVVHDF. Four children received red
cells transfusion and 1 received platelets
transfusion. Patients were discharged
after 1, 4, 7, 5, 7 days in PICU. One
patient was readmitted for plasma
exchange therapy. One patient had 4
courses of intermittent hemodialysis
after PICU discharge. Conclusion:
Recent technological progress has made
CVVHDF safer and more reliable in
young children. It allows a tighter
control of fluid and electrolyte balances
in the first hours of treatment without
hemodynamic impairment. Vascular
access can be used for intermittent
dialysis and/or plasma exchange therapy.
Even in the absence of contra indication
for PD, first intention CVVHDF for
young children with HUS is feasible and
showed no major safety issue in this
small case series.
67. Post Filter Ionized Calcium Levels
With Dilute Regional Citrate
Anticoagulation: Do We Need To
Follow Them?
Rajesh Speer, Dmitri Sychev, Ashita
Tolwani
University of Alabama at Birmingham
Background: Although regional citrate
anticoagulation (RCA) with continuous
venovenous hemodiafiltration
(CVVHDF) has been shown to be safe
and effective, it requires intensive
monitoring of ionized calcium (iCa)
levels every 6 hours <strong>from</strong> the patient as
well as the circuit. At the University of
Alabama at Birmingham (UAB),
CVVHDF is performed with a .5%
dilute citrate solution that serves as both
an anticoagulant and replacement fluid
(RF). Post filter iCa levels are checked
every 6 hours and citrate adjusted to
maintain a post filter iCa level of < .5
mmol/L. The purpose of this study was
to determine if measuring post filter iCa
levels every 6 hours are necessary with
the typical citrate RF and blood flow rate
ranges used at UAB. Methods: This is a
prospective analysis of post filter iCa
levels in 1 critically ill patients using
pre-dilution CVVHDF. Post filter iCa
levels were checked at varying
combinations of citrate RF ranges of 15
to 25 ml/hr, dialysate ranges of 15 to 25
ml/hr, and blood flow rate ranges of 15
to 2 ml/min. Patient demographics,
electrolytes, as well as dialysate
parameters were reviewed. Results: Post
filter iCa levels remained