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 87. Mars System for Acute Liver Failure due to Hepatitis A, Complicated y Acute Renal Failure. Case Presentation Janette Estefan-Garfias, Mario A Sebastián-Díaz, Porfirio Visoso- Palacios Hospital Central de Alta Especialidad del Sur. Petróleos Mexicanos A 26-year-old man with weakness, adynamia, vomit, and abdominal pain was admitted in August 21. Patient was administered acetaminophen and quinolones for suspected infectious gastroenteritis. Five days later the patient showed at the emergency room and was admitted to the hospital for various tests and diagnosed with infection due to hepatitis A, IgM positive. His symptoms were treated, and he was discharged 24 hours later. He returned three days later, and due to elevated hepatic enzymes and oral intolerance, he was transferred to the ICU and administered hemodialysis due to overhydration, anuria, metabolic acidosis, and nitrogen retention. Due to lack of response, he was transferred to our unit, where the diagnosis was confirmed: hepatitis A seropositive and hepatitis B, C, CMV, and Epstein-Barr negative. Upon admission, he presented bleeding at the catheter insertion site and thrombosis of the right basilic vein. Anticoagulation was performed using LMWH, then orally. On September 17, once coagulation times had improved, the catheter was removed and relocated to left jugular level. The Molecular Adsorbents Recirculating System (MARS) was used. Patient received five eight-hour sessions with hemodialysis, bicarbonate buffer, UF 5 mL, QB 2 mL/min, QD 5 mL/min, 6 mL of human albumin 2% with no complications. Liver function tests showed improvement and a decrease in bilirubin levels after each session. The patient began urination after the first session (.5 mL/kg/hr) and entered into the polyuric phase eight days later, recovering full renal function three months later. The patient presented nosocomial pneumonia caused by Staphylococcus Epidermidis and was administered Meropenem with an adequate response. Albumin causes the amalgamation of a large amount of substances implied in the development of hepatorenal syndrome, hepatic encephalopathy, and hemodynamic instability, and the MARS system has been associated with improved bilirubin and ammonia levels and, therefore, improved encephalopathy and hepatic regeneration. Although there are no studies that absolutely support this type of procedure, it is evident that its use and multidisciplinary support make the pathology to present fewer complications and a better outcome. 88. The Hemodynamic effects during Sustained low-efficiency dialysis versus Continuous veno-venous hemofiltration for patients with intracranial hypertension in a cross over study Chih-Chin Kao, Vin-Cent Wu, Dow- Ming Huang , Chin Fu Lai, Pi-Ru Tsai , Wen-Je Ko , Kwan-Dun Wu National Taiwan University hospital, Taipei, Taiwan Background: Hemodynamic instability occurs frequently during dialysis treatment and still remains as significant cause of patient mobility and mortality, especially in patients with increased intra-cerebral pressure (ICP). This study was to compare the ICP and hemodynamic parameters between the sustained low-efficiency dialysis (SLED) and continuous veno-venous 191
<strong>ABSTRACTS</strong> FROM 17 TH INTERNATIONAL CONFERENCE ON CRRT, SAN DIEGO, FEB 14-17, 2012 hemofiltration (CVVH) in end- stage renal disease (ESRD) patients. Methods: ESRD patients with increased ICP status post ICP monitor insertion were enrolled. Patients were randomized to receive CVVH or SLED first and then the other the next day. The ICP monitor was equipped and the indwelling radial artery catheter connected to the FloTrac/Vigileo hemodynamic monitoring system and for whom the ultrafiltration rate was set around 1. kg/8hr to 1.5 kg/8hr according to fluid status. Results: Ten patients (6 female, mean age: 59.9 ± 11.9 years) were analyzed. The disease severity assessed by APACHE II was 28. ± 5.1 at the enrollment. There were no significant differences of blood pressure, heart rate, cardiac output, and cardiac index between the SLED and CVVH. The stroke volume was increased 7.5 ± 18.1 % in CVVH and -.1% ± 13.7% in SLED patients at 6 hours after dialysis. The stoke volume index also increased 8.8% ± 17.3% in CVVH and -2.9 ± 15.6% in SLED at 6 hours after dialysis. The stroke volume variation was significant different in CVVH <strong>from</strong> SLED (87.9 ± 27.% vs -13. ± 24.7%, p=.42) . The modality effect on stroke volume, stroke volume index and stroke volume variation were all significant (p
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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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D28 Extracorporeal Techniques for S
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E29 Heart Failure and Cardio-Renal
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F30 Ensuring Patient Safety and Qua
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H32 Withdrawing & Withholding Suppo
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Patel SS, Holley JL. Withholding an
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