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

C11
Critical Care Management: Nutrition Assessment and Delivery
Educational Objectives:
- Nutritional impact of sepsis and CRRT
- Amino-Acid, vitamins and trace elements needs with and without CRRT
- Amino-Acid, vitamins and trace elements management during CRRT
Oliver Joannes-Boyau MD
8:15-9:45
Wednesday, February 15
Content Description:
Continuous renal replacement techniques as sepsis have an impact on nutritional status of patients in ICU. It is
important to know the exact removal power of hemofiltration on amino-acids and trace elements and how we can
counter this. There are some articles and small studies in the literature that focus on this subject, but with low
level results and few recommendations. In the IVOIRE study amino-acids and trace elements were dosed at different
times to follow the level of removal of these along time and to try to find simple tips to avoid nutritional
deficit in the future. For septic patients, antibiotics are also crucial and we know that CRRT has a high potential
of removal for these molecules. A review of literature and the results <strong>from</strong> IVOIRE study will be presented with
new recommendations for good antibiotic given procedures in the future.
Suggested Reading:
1. Bouman CS, van Kan HJ, Koopmans RP, Korevaar JC, Schultz MJ, Vroom MB. Discrepancies between
observed and predicted continuous venovenous hemofiltration removal of antimicrobial agents in critically ill
patients and the effects on dosing. Intensive Care Med 2006;32(12):2013-9.
2. Bugge JF. Pharmacokinetics and drug dosing adjustments during continuous venovenous hemofiltration or
hemodiafiltration in critically ill patients. Acta Anaesthesiol Scand 2001;45(8):929-34.
3. Roberts JA, Lipman J. Pharmacokinetic issues for antibiotics in the critically ill patient. Crit Care Med
2009;37(3):840-51; quiz 859.
4. Berger MM, Shenkin A, Revelly JP, et al. Copper, selenium, zinc, and thiamine balances during continuous
venovenous hemodiafiltration in critically ill patients. Am J Clin Nutr 2004;80(2):410-6.
5. Berger MM, Shenkin A. Vitamins and trace elements: practical aspects of supplementation. Nutrition
2006;22(9):952-5.
6. Marin A, Hardy G. Practical implications of nutritional support during continuous renal replacement therapy.
Curr Opin Clin Nutr Metab Care 2001;4(3):219-25.
7. Valencia E, Marin A, Hardy G. Nutrition therapy for acute renal failure: a new approach based on 'risk, injury,
failure, loss, and end-stage kidney' classification (RIFLE). Curr Opin Clin Nutr Metab Care 2009;12(3):241-4.
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