The effect of continuous venovenous hemodiafiltration on amino acid delivery, clearance, and removal in children.

Autor:	Lion, Richard P, Vega, Molly R, Smith, E O'Brien, Devaraj, Sridevi, Braun, Michael C, Bryan, Nathan S, Desai, Moreshwar S, Coss-Bu, Jorge A, Ikizler, Talat Alp, Akcan Arikan, Ayse
Předmět:	INTENSIVE care units LENGTH of stay in hospitals STATISTICAL significance SCIENTIFIC observation CRITICALLY ill TIME NUTRITION PATIENTS PEDIATRICS TERTIARY care HEALTH outcome assessment REGRESSION analysis MATHEMATICAL variables SURVIVAL analysis (Biometry) DESCRIPTIVE statistics AMINO acids HEMODIALYSIS HEMODYNAMICS DATA analysis software ACUTE kidney failure BLOOD filtration LONGITUDINAL method DIETARY proteins BLOOD flow measurement CHILDREN
Zdroj:	Pediatric Nephrology; Feb2022, Vol. 37 Issue 2, p433-441, 9p, 4 Charts, 2 Graphs
Abstrakt:	Background: In critically ill children with acute kidney injury (AKI), continuous kidney replacement therapy (CKRT) enables nutrition provision. The magnitude of amino acid loss during continuous venovenous hemodiafiltration (CVVHDF) is unknown and needs accurate quantification. We investigated the mass removal and clearance of amino acids in pediatric CVVHDF. Methods: This is a prospective observational cohort study of patients receiving CVVHDF from August 2014 to January 2016 in the pediatric intensive care unit (PICU) of a tertiary children's hospital. Results: Fifteen patients (40% male, median age 2.0 (IQR 0.7, 8.0) years) were enrolled. Median PICU and hospital lengths of stay were 20 (9, 59) and 36 (22, 132) days, respectively. Overall survival to discharge was 66.7%. Median daily protein prescription was 2.00 (1.25, 2.80) g/kg/day. Median daily amino acid mass removal was 299.0 (174.9, 452.0) mg/kg body weight, and median daily amino acid mass clearance was 18.2 (13.5, 27.9) ml/min/m2, resulting in a median 14.6 (8.3, 26.7) % protein loss. The rate of amino acid loss increased with increasing dialysis dose and blood flow rate. Conclusion: CVVHDF prescription and related amino acid loss impact nutrition provision, with 14.6% of the prescribed protein removed. Current recommendations for protein provision for children requiring CVVHDF should be adjusted to compensate for circuit-related loss. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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