Dual Dialysis for Post-bilateral Orthotopic Lung Transplantation Hyperammonemia.

Autor: Bhattacharyya A; Internal Medicine, University of Maryland, Baltimore, USA., Ayele GM; Internal Medicine, Howard University Hospital, Washington, D.C., USA., Zinabu SW; Internal Medicine, Howard University Hospital, Washington, D.C., USA., Atalay RT; Internal Medicine, Howard University Hospital, Washington, D.C., USA., Mohammed A; Internal Medicine, Howard University Hospital, Washington, D.C., USA., Siraga M; Internal Medicine, Howard University Hospital, Washington, D.C., USA., Gao L; Internal Medicine, Howard University Hospital, Washington, D.C., USA., Adithya Sateesh B; Medicine, University of Maryland, Baltimore, USA.; Medicine, American University of Antigua, St John's, ATG., Gasmelseed H; Internal Medicine, Howard University Hospital, Washington, D.C., USA., Michael MB; Internal Medicine, Howard University Hospital, Washington, D.C., USA.; Internal Medicine, University of Maryland, Baltimore, USA.
Jazyk: angličtina
Zdroj: Cureus [Cureus] 2024 Jul 01; Vol. 16 (7), pp. e63607. Date of Electronic Publication: 2024 Jul 01 (Print Publication: 2024).
DOI: 10.7759/cureus.63607
Abstrakt: Hyperammonemia is a metabolic disorder characterized by supraphysiologic ammonia (NH 3 ) concentrations in the blood. Although usually seen in adults with liver disease, hyperammonemia is a notable complication in 4.1% of lung transplants. It is associated with cerebral edema and neurological dysfunction and carries up to 75% mortality in critically ill patients. Opportunistic infections caused by Mycoplasma and Ureaplasma species have been implicated as the cause of this metabolic disturbance. Literature in neonates has shown that renal replacement therapy (RRT) is the best choice for treating patients with neurologic manifestations of hyperammonemia, in cases of NH3 clearance than continuous renal replacement therapy (CRRT). In contrast, continuous venovenous hemodialysis (CVVHD) is usually better tolerated for patients with hemodynamic instability for NH 3  clearance. NH 3  is a small molecule whose clearance mirrors urea in dialysis. Even though RRT can be a treatment modality for hyperammonemia in adults and neonates, there is very little literature on adults. We present a unique case demonstrating improvement in neurologic manifestations of hyperammonemia by using both IHD and CVVHD in an adult patient.
Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.
(Copyright © 2024, Bhattacharyya et al.)
Databáze: MEDLINE
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