Continuous Venovenous Hemofiltration to Reduce Mortality in Severely Burned Patients

2016 ◽  
pp. 81-85
Author(s):  
Kevin K. Chung
Keyword(s):  
Continuous Venovenous Hemofiltration

Treatment of hyperammonemia using in-line renal replacement and hyperosmolar therapies within an extracorporeal membrane oxygenation circuit

Perfusion ◽  
2021 ◽  
pp. 026765912110359
Author(s):  
Alison Grazioli ◽  
Jamie E Podell ◽  
Aldo Iacono ◽  
Alexander Sasha Krupnik ◽  
Ronson J Madathil ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Cerebral Edema ◽  
Urea Cycle ◽  
Rare Complication ◽  
Volume Of Distribution ◽  
Intermittent Hemodialysis ◽  
Treatment Goals ◽  
Continuous Venovenous Hemofiltration ◽  
Small Molecular Weight ◽  
Membrane Oxygenation

After orthotopic lung transplantation, hyperammonemia can be a rare complication secondary to infection by organisms that produce urease or inhibit the urea cycle. This can cause neurotoxicity, cerebral edema, and seizures. Ammonia is unique in that it has a large volume of distribution. However, it is also readily dialyzable given its small molecular weight. As such, removal of ammonia requires renal replacement modalities that can both rapidly remove ammonia from the plasma space and allow for continuous removal to prevent rebound accumulation from intracellular stores. Prevention of iatrogenic osmotic lowering in this setting is required to prevent worsening of cerebral edema. Herein, we describe use of sequential in-line renal replacement therapy using both intermittent hemodialysis and continuous venovenous hemofiltration within an extracorporeal membrane oxygenation circuit in conjunction with higher sodium dialysate and 7.5% hypertonic saline to achieve these treatment goals.

scholarly journals Once-Daily Amikacin Dosing in Burn Patients Treated with Continuous Venovenous Hemofiltration

2011 ◽  
Vol 55 (10) ◽  
pp. 4639-4642 ◽  
Author(s):  
Kevin S. Akers ◽  
Jason M. Cota ◽  
Christopher R. Frei ◽  
Kevin K. Chung ◽  
Katrin Mende ◽  
...  
Keyword(s):  
Burn Injury ◽  
Continuous Venovenous Hemofiltration ◽  
Burn Patients ◽  
Small Reduction ◽  
Target Attainment ◽  
Clinical Pharmacokinetics ◽  
Once Daily ◽  
Renal Replacement Therapies ◽  
Rapid Clearance ◽  
The Impact

ABSTRACTAmikacin clearance can be increased in burn injury, which is often complicated by renal insufficiency. Little is known about the impact of renal replacement therapies, such as continuous venovenous hemofiltration (CVVH), on amikacin pharmacokinetics. We retrospectively examined the clinical pharmacokinetics, bacteriology, and clinical outcomes of 60 burn patients given 15 mg/kg of body weight of amikacin in single daily doses. Twelve were treated with concurrent CVVH therapy, and 48 were not. The pharmacodynamic target of ≥10 for the maximum concentration of drug in serum divided by the MIC (Cmax/MIC) was achieved in only 8.5% of patients, with a small reduction ofCmaxin patients receiving CVVH and no difference in amikacin clearance. Mortality and burn size were greater in patients who received CVVH. Overall, 172 Gram-negative isolates were recovered from the blood cultures of 39 patients, with amikacin MIC data available for 82 isolates from 24 patients. A 10,000-patient Monte Carlo simulation was conducted incorporating pharmacokinetic and MIC data from these patients. The cumulative fraction of response (CFR) was similar in CVVH and non-CVVH patients. The CFR rates were not significantly improved by a theoretical 20 mg/kg amikacin dose. Overall, CVVH did not appear to have a major impact on amikacin serum concentrations. The low pharmacodynamic target attainment appears to be primarily due to higher amikacin MICs rather than more rapid clearance of amikacin related to CVVH therapy.

Plasmapheresis combined with continuous venovenous hemofiltration in surgical patients with sepsis

2000 ◽  
Vol 26 (5) ◽  
pp. 532-537 ◽  
Author(s):  
J. Schmidt ◽  
S. Mann ◽  
V. D. Mohr ◽  
R. Lampert ◽  
U. Firla ◽  
...  
Keyword(s):  
Surgical Patients ◽  
Continuous Venovenous Hemofiltration

Lacosamide Pharmacokinetics in a Critically Ill Patient Receiving Continuous Venovenous Hemofiltration

2017 ◽  
Vol 38 (2) ◽  
pp. e17-e21 ◽  
Author(s):  
Miguel J. Franquiz ◽  
Shamir N. Kalaria ◽  
Michael J. Armahizer ◽  
Mathangi Gopalakrishnan ◽  
Paul J. McCarthy ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patient ◽  
Continuous Venovenous Hemofiltration

Pharmacokinetic Evaluation of Voriconazole Treatment in Critically Ill Patients Undergoing Continuous Venovenous Hemofiltration

2011 ◽  
Vol 33 (4) ◽  
pp. 393-397 ◽  
Author(s):  
Jaroslav Radej ◽  
Ales Krouzecky ◽  
Pavel Stehlik ◽  
Roman Sykora ◽  
Jiri Chvojka ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Continuous Venovenous Hemofiltration ◽  
Pharmacokinetic Evaluation

Indications for Dialysis in Acute Kidney Injury

2020 ◽  
Author(s):  
Ankit Patel ◽  
Kenneth B Christopher
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
High Efficiency ◽  
Kidney Injury ◽  
Intermittent Hemodialysis ◽  
Continuous Venovenous Hemofiltration ◽  
Continuous Venovenous Hemodialysis ◽  
Low Efficiency ◽  
The Impact

Renal replacement therapy (RRT) can be used to support patient’s kidney function in cases of acute kidney injury (AKI). However, timing, modality, and dosing of RRT continue to remain in question. Recent studies have begun to provide data to help guide clinicians on when to initiate RRT, what form of RRT to use ranging from continuous venovenous hemofiltration (VVH) to intermittent hemodialysis, and the impact of high versus low-intensity dosing. Additionally, the risks associated with temporary vascular access with regard to thrombosis and infection, the impact of high efficiency and flux versus low efficiency and flux membranes, and options for anticoagulation in RRT for AKI are also discussed. This review contains 75 references.  Key words: acute kidney injury, chronic kidney disease, continuous venovenous hemofiltration, continuous venovenous hemodialysis, renal replacement therapy, venovenous hemofiltration, 

scholarly journals Linezolid and Continuous Venovenous Hemofiltration

2006 ◽  
Vol 42 (3) ◽  
pp. 435-436 ◽  
Author(s):  
B. Meyer ◽  
F. Thalhammer
Keyword(s):  
Continuous Venovenous Hemofiltration
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