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

<strong>ABSTRACTS</strong> FROM 17 TH INTERNATIONAL CONFERENCE ON CRRT,
SAN DIEGO, FEB 14-17, 2012
LMWH in group B (loading dose of
LMWH 4IU/kg, maintenance dose
4IU/kg/hr), and regional citrate plus low
dose of LMWH in group C(loading dose
2IU/kg, maintenance dose 2IU/kg/hr).
The filter survival time, the change of
hemoglobin (Hb), platelet counts (PLT),
and anticoagulation-related side effects
were measured. Results: Fifty-three
patients completed the study and entered
into data analysis, 15 in group A, 19 in
group B and C. The mean APACHEII
scores in each group were 16.2 ± 3.65,
17.11 ± 3.5 and 17.1 ± 4.79, respectively
(P>.5). There were no significant
differences in age, gender, weight,
baseline values of Hb, PLT, prothrombin
time, activated partial thromboplastin
time, blood pH, and bicarbonate
concentration between 3 groups. The
filter survival time were 21.22 ± 3.48h in
group A, 25.1 ± 5.5 h in group B, and
4.35 ± 7.8h in group C (p .5). The %age of patients with
reduction of platelet counts more than
3% were 2% in group A, 31.6% in group
B, and 15.7% in group C(P>.5). The
mortality rate was 4% in group A, 26.3%
in group B and 36.8% in group C,
respectively (P>.5). There were no
differences in the CVVH duration,
hospital days and ICU days between 3
groups. Conclusion: compared with
anticoagulation using only regional
citrate or LMWH, regional citrate plus
low dose of LMWH protocol is more
efficacy in prolonging filter life span,
without significant increase of
anticoagulation-related complications.
RRT RESEARCH
72. Continuous Venovenous
Hemodialysis (CVVHD) Effluent
Imipenem Levels Predict Plasma
Free Imipenem Levels
Seth R Bauer, Milen Amde, Michael J
Connor, Charbel A Salem, William H
Fissell
Cleveland Clinic, Emory University
Background: Pharmacokinetic and
pharmacodynamic studies typically
require time-intensive sampling
strategies that may exceed clinician and
or Institutional Review Board comfort
levels with blood loss due to
phlebotomy. These concerns are
heightened in the critical care
environment. CVVHD effluent is
typically well equilibrated with plasma,
and most antibiotics in common use in
the ICU are small molecules, suggesting
that effluent drug levels might predict
free plasma levels. We conducted an
IRB-approved prospective observational
study comparing antibiotic levels in
CVVHD effluent with those in plasma.
Here, we present data <strong>from</strong> 17 patients
treated with concomitant CVVHD and
imipenem. Methods: Inclusion: Adult
patients with acute or chronic renal
failure who were receiving CVVHD in
the ICU. Exclusion: ESLD, pregnancy.
Patient data: age, gender, current and
admission weight, CVVHD doses were
recorded on case report forms (CRFs).
Sampling: After the fourth dose of
antibiotic during uninterrupted CVVHD,
trough, 3 minute post infusion peak, and
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