TY - JOUR
T1 - Continuous renal replacement therapy amino acid, trace metal and folate clearance in critically ill children
AU - Zappitelli, Michael
AU - Juarez, Marisa
AU - Castillo, L.
AU - Coss-Bu, Jorge
AU - Goldstein, Stuart L.
N1 - Funding Information:
Acknowledgments We acknowledge Amrita Naipaul for her assistance in data collection and Walter O’Rourke (Dialysis Solutions Inc.) and Lee Ware (Baxter Healthcare) for their financial support. Dr. Zappitelli received a post-doctoral research fellowship award from the Kidney Research Scientist Core and National Training Program to fund his training at the Baylor College of Medicine/Texas Children’s Hospital Acute Care Nephrology Research Fellowship.
PY - 2009/4
Y1 - 2009/4
N2 - Purpose: We hypothesized continuous veno-venous hemodialysis (CVVHD) amino acid, trace metals and folate clearance impacts nutrient balance. Methods: Critically ill children receiving CVVHD were studied prospectively for 5 days. Blood concentrations (amino acids, copper, zinc, manganese, chromium, selenium and folate) were measured at CVVHD initiation, and Days 2 and 5. CVVHD clearance, losses and nutrient balances were calculated on Days 2 and 5. Results: We studied 15 children aged 7.7 ± 6.7 years. Nitrogen balance was negative on Days 2 and 5. Amino acid clearances ranged from 2.8 to 51.1 ml/min per 1.73 m2. CVVHD losses corresponded to 20% of intake. Days 2 and 5 balances were negative for selenium, but positive for other trace metals. Folate clearance was 16 ml/min per 1.73 m2 on Days 2 and 5 and serum concentrations decreased significantly from initiation to Day 5 (P < 0.05). Conclusions: Nutrient losses by CVHHD may impact adequate nutrition provision.
AB - Purpose: We hypothesized continuous veno-venous hemodialysis (CVVHD) amino acid, trace metals and folate clearance impacts nutrient balance. Methods: Critically ill children receiving CVVHD were studied prospectively for 5 days. Blood concentrations (amino acids, copper, zinc, manganese, chromium, selenium and folate) were measured at CVVHD initiation, and Days 2 and 5. CVVHD clearance, losses and nutrient balances were calculated on Days 2 and 5. Results: We studied 15 children aged 7.7 ± 6.7 years. Nitrogen balance was negative on Days 2 and 5. Amino acid clearances ranged from 2.8 to 51.1 ml/min per 1.73 m2. CVVHD losses corresponded to 20% of intake. Days 2 and 5 balances were negative for selenium, but positive for other trace metals. Folate clearance was 16 ml/min per 1.73 m2 on Days 2 and 5 and serum concentrations decreased significantly from initiation to Day 5 (P < 0.05). Conclusions: Nutrient losses by CVHHD may impact adequate nutrition provision.
KW - Continuous veno-venous hemodialysis
KW - Intensive care
KW - Nutrition
KW - Pediatric
KW - Protein
KW - Vitamins
UR - http://www.scopus.com/inward/record.url?scp=62949131344&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=62949131344&partnerID=8YFLogxK
U2 - 10.1007/s00134-009-1420-9
DO - 10.1007/s00134-009-1420-9
M3 - Article
C2 - 19183946
AN - SCOPUS:62949131344
SN - 0342-4642
VL - 35
SP - 698
EP - 706
JO - Intensive care medicine
JF - Intensive care medicine
IS - 4
ER -