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

More documents

Recommendations

Info

<strong>ABSTRACTS</strong> FROM 17 TH INTERNATIONAL CONFERENCE ON CRRT, SAN DIEGO, FEB 14-17, 2012 with AoCLF; no improvement was witnessed in the 2 patients with ALF. HESA and GCS scores remained stable or improved in all 5 patients. Conclusion: Despite the high mortality rate, patients with AKI and liver failure benefit <strong>from</strong> treatment with MARS and CVVHDF which increases the time until a liver transplant can be performed. Indication for MARS Days on MARS Outcome Change in HESA Change in GCS Change in total bilirubin Change in creatinine Pt 1 Pt 2 Pt 3 Pt 4 Pt 5 Hep B cirrhosis Hep C cirrhosis Acetami nophen induced acute liver failure Nonalc oholic steato hepatiti s cirrhosi s 4 5 1 2 1 Discharg ed on Dialysis Liver Transpla nt Liver Transpl ant Death Liver lympho ma Death 1 (3->2) 1 (3->2) N/A N/A N/A 7 to 15 15 to 15 5 to 5 3 to 3 7 to 7 ↓49.2% ↓17.2% ↑165.6 % ↓58.3% ↓76.2% ↓34.2% ↓66% ↓12.8% ↑6.4% ↓32.1 % 90. Impact of Albumin Dialysis on Albumin Binding Function Jan Stange, Maria Kretschmann, Sarah Froehlich, Birka Krellenberg, Melanie Stiffel, Sebastian Koball, Joerg Henschel, Martin Gloger, Martin Eggert, Steffen Mitzner Center for Organ Support & Regeneration, Dept. Medicine, Intensive Care Unit Background: Liver Failure is associated with an accumulation of endogenous toxins at the main albumin binding site for multiple vasoactive, neuro-, nephroand hepatotoxic metabolites (Klammt et al. EJGH 27). The resulting binding dysfunction can be quantified using fluorescence markers competing for binding sites with said toxins The Albumin Binding Capacity (ABiC) correlates with mortality. Patients in who ABiC can be improved within 7 days have a mortality of only 6.25% while patients who maintain a low binding capacity below 4% over 7 days despite treatment have a mortality of 83% (Klammt et. al. Liver Transplantation 28). Therapeutic means to improve ABiC include extracorporeal detoxification removing albumin bound toxins and infusion of albumin. The effect of the latter is limited by the occupation of therapeutic albumin binding sites by commercial conservatives such as Caprylate and N- Acetyltryptophane (Stange et al. Liver Transplantation 211). Since Albumin Dialysis so far is based on commercial albumin as Dialysate the effect of stabilizers on capability to improve ABiC was investigated. Methods: Plasma samples were taken before and after Mars treatments in patients suffering <strong>from</strong> liver failure. Bilirubin, Bile Acids and ABiC was measured before and after treatments and 193
<strong>ABSTRACTS</strong> FROM 17 TH INTERNATIONAL CONFERENCE ON CRRT, SAN DIEGO, FEB 14-17, 2012 compared by paired tests. Results: MARS resulted into a significant reduction of bilirubin and bile acids, however, despite this effective removal, the effect of individual MARS treatments on albumin binding function did not reach significance. Caprylate measurements in the albumin dialysate compartment of the MARS circuit revealed caprylate concentrations of 1.53 umol caprylate/umol albumin, despite pre-circulations of the albumin circuit of 3 minutes over adsorbents according to the manufacturer`s specifications may resolve this problem. Conclusion: Improvement of patients ABiC by albumin dialysis requires a higher ABiC of Dialysate Albumin than Patients Albumin. Although pretreatment recirculation of the MARS Circuit for 3 minutes can reduce the caprylate/albumin ratio, a target of less than .3 umol caprylate/umol albumin cannot be achieved in the current set up, which would be required to achieve an albumin binding capacity of >95% in the MARS Circuit. 194
Page 2 and 3:
CRRT 2012 SEVENTEENTH INTERNATIONAL
Page 4 and 5:
FACULTY DISCLOSURES CRRT 2012 Facul
Page 6 and 7:
CRRT 2012 ORGANIZING COMMITTEE USA
Page 8 and 9:
CRRT 2012 FACULTY Patrick Honoré,
Page 10 and 11:
ACKNOWLEDGEMENTS CRRT 2012 ACKNOWLE
Page 12 and 13:
PLENARY SESSIONS CRRT 2012 PROGRAM/
Page 14 and 15:
Page 16 and 17:
Page 18 and 19:
WORKSHOPS CRRT 2012 PROGRAM/INDEX T
Page 20 and 21:
WORKSHOPS CRRT 2012 PROGRAM/INDEX W
Page 22 and 23:
POSTER ABSTRACTS C
Page 24 and 25:
POSTER ABSTRACTS C
Page 26 and 27:
NURSING FORUM LUNCHEON Communicatio
Page 28 and 29:
Nutritional Support in ICU Patients
Page 30 and 31:
Educational Objectives: The Endothe
Page 32 and 33:
SPECIAL LECTURE Engineering Critica
Page 34 and 35:
Nishimura R, Ornato JP, Page RL, Ri
Page 36 and 37:
Do Vasoactive Drugs and Fluids Impr
Page 38 and 39:
Blood Transfusions are Important fo
Page 40 and 41:
Thinking Outside of the Box: A Nove
Page 42 and 43:
Nursing Forum 2 Luncheon Benchmarki
Page 44 and 45:
4. Mori K, Lee HT, Rapoport D, Drex
Page 46 and 47:
Differential Diagnosis of AKI: Can
Page 48 and 49:
Myocardial Stunning and Brain Edema
Page 50 and 51:
4. Udy A, Roberts JA, Lipman J. Wha
Page 52 and 53:
CRRT and ECMO: Techniques and Outco
Page 54 and 55:
Management of Severe Heart Failure:
Page 56 and 57:
Avoiding Anticoagulation for CRRT:
Page 58 and 59:
Improving Outcomes from</st
Page 60 and 61:
The Changing Face of AKI: Snapshots
Page 62 and 63:
Alkaline Phosphatase Peter Pickkers
Page 64 and 65:
creatinine (Cr) was measured using
Page 66 and 67:
Surveillance and Early Recognition
Page 68 and 69:
therapy admitted to general intensi
Page 70 and 71:
A01 Assessing the Microcirculation
Page 72 and 73:
A01 Assessing the Microcirculation
Page 74 and 75:
C03 Critical Care Pharmacology: Vas
Page 76 and 77:
D04 Biomarkers 1: Principles and Ap
Page 78 and 79:
6. Ferguson JW, Dover AR, Chia S, C
Page 80 and 81:
G07 Fluids and Solutions in the Cri
Page 82 and 83:
A09 Vascular Access /Membrane and C
Page 84 and 85:
A09 Vascular Access /Membrane and C
Page 86 and 87:
C11 Critical Care Management: Nutri
Page 88 and 89:
D12 Biomarkers 2: Application in AK
Page 90 and 91:
Educational Objectives: E13 Liver a
Page 92 and 93:
G15 Fluids and Solutions in the Cri
Page 94 and 95:
Educational Objectives: 1) Discuss
Page 96 and 97:
B18 Fluid Management Ravindra L. Me
Page 98 and 99:
C19 Acid Base and Electrolyte Probl
Page 100 and 101:
D20 Extracorporeal Techniques for S
Page 102 and 103:
the mediatordelivery hypothesis. In
Page 104 and 105:
F22 Ensuring Patient Safety and Qua
Page 106 and 107:
H24 Patient Centered Care in the IC
Page 108 and 109:
B26 Starting and Stopping RRT for A
Page 110 and 111:
C27 Acid Base and Electrolyte Probl
Page 112 and 113:
D28 Extracorporeal Techniques for S
Page 114 and 115:
E29 Heart Failure and Cardio-Renal
Page 116 and 117:
F30 Ensuring Patient Safety and Qua
Page 118 and 119:
H32 Withdrawing & Withholding Suppo
Page 120 and 121:
Patel SS, Holley JL. Withholding an
Page 122 and 123:
ABSTRACTS FROM 17
Page 124 and 125:
ABSTRACTS FROM 17
Page 126 and 127:
ABSTRACTS FROM 17
Page 128 and 129:
ABSTRACTS FROM 17
Page 130 and 131:
ABSTRACTS FROM 17
Page 132 and 133:
ABSTRACTS FROM 17
Page 134 and 135:
ABSTRACTS FROM 17
Page 136 and 137:
ABSTRACTS FROM 17
Page 138 and 139:
ABSTRACTS FROM 17
Page 140 and 141:
ABSTRACTS FROM 17
Page 142 and 143:
ABSTRACTS FROM 17
Page 144 and 145: ABSTRACTS FROM 17
show all

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

Create successful ePaper yourself

Delete template?

Save as template?