Electrolytes-Enriched Hemodiafiltration Solutions for Continuous Renal Replacement Therapy in Acute Kidney Injury: A Crossover Study

International audienceAIMS:To evaluate the capability of an electrolytes-enriched solution to prevent metabolic disorders during continuous veno-venous hemodiafiltration (CVVHDF).METHODS:Serum biochemistry and clinical tolerance were compared during CVVHDF treatments with an electrolyte-enriched (Phoxilium) or standard solutions in 10 acute renal failure patients.RESULTS:As compared to standard fluids, serum potassium and phosphate levels were maintained in the normal range with Phoxilium without any supplementation but total serum calcium levels were significantly lower. Bicarbonatemia was slightly higher (24-26 vs. 21.5-24.5 mmol/l, p 7.44). Despite the absence of glucose in the Phoxilium solution, blood glucose levels and glucose supplementation were similar between treatments. Clinical tolerance and efficiency of CVVHDF sessions were comparable.CONCLUSION:Phoxilium effectively prevented hypophosphatemia and hypokalemia during CVVHDF. It was, however, associated with a slight metabolic acidosis and hypocalcemia compared with conventional solutions

Mortality Associated with Night and Weekend Admissions to ICU with On-Site Intensivist Coverage: Results of a Nine-Year Cohort Study (2006-2014)

International audienc

Continuous Veno-Venous High Cut-Off Hemodialysis Compared to Continuous Veno-Venous Hemodiafiltration in Intensive Care Unit Acute Kidney Injury Patients

International audienceHigh cut-off (HCO) continuous veno-venous hemodialysis (CVVHD) was compared to high-flux membrane (HFM) continuous veno-venous hemodiafiltration (CVVHDF) in intensive care unit (ICU) acute kidney injury (AKI) in terms of efficiency, hemodynamic tolerance, medium-sized molecules removal, albumin loss, and inflammatory system activation

Flow-chart of the study population.

<p>Flow-chart of the study population.</p

Comparison of patients admitted during on-hours to those admitted during weeknights, and to those admitted during weekends and public holidays.

<p>Weekend admission was defined as admission between 08:00 am Sunday and 7:59 am Monday; BMI: body mass index; SAPS II: simplified acute physiology score II; ICU: intensive care unit; LOS: length of stay; “SAMU”: Service d’Aide Médicale Urgente: mobile emergency team; p: On-hours vs Week-night; p*: On-hours vs weekends and public holidays.</p

Univariate Cox model of factors associated with ICU mortality.

<p>* As compared with female; Ref: reference category; reduced staff: weekend and public holydays admissions; RRT: renal replacement therapy; “SAMU”: <b>S</b>ervice d’<b>A</b>ide <b>M</b>édicale <b>U</b>rgente: mobile emergency team.</p

Demographic and epidemiological characteristics of the studied population at the admission to the ICU; management, ICU length of stay and mortality.

<p>BMI: body mass index; SAPS II: simplified acute physiology score II; ICU: intensive care unit; LOS: length of stay; “SAMU”: <b>S</b>ervice d’<b>A</b>ide <b>M</b>édicale <b>U</b>rgente: mobile emergency team.</p

Multivariate Cox model of factors associated with ICU mortality.

<p>Included variables in the analysis: age, sex, BMI, SAPS II, nutritional status, admission source, hospital admission category, reason for admission, life support treatments.</p

Comparison of patients admitted during on-hours and off-hours.

<p>BMI: body mass index; SAPS II: simplified acute physiology score II; ICU: intensive care unit; LOS: length of stay; “SAMU”: <b>S</b>ervice d’<b>A</b>ide <b>M</b>édicale <b>U</b>rgente: mobile emergency team.</p

Characteristics of patients admitted per time variable regardless of type of the day (working days or not).

<p>BMI: body mass index; SAPS II: simplified acute physiology score II; ICU: intensive care unit; LOS: length of stay; “SAMU”: <b>S</b>ervice d’<b>A</b>ide <b>M</b>édicale <b>U</b>rgente: mobile emergency team; MV: mechanical ventilation. p = significance as compared to group admitted from 08:00 to 17:59.</p