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Intensive Care Medicine
Published in: Intensive Care Medicine 4/2009

01-04-2009 | Pediatric Original

Continuous renal replacement therapy amino acid, trace metal and folate clearance in critically ill children

Authors: Michael Zappitelli, Marisa Juarez, L. Castillo, Jorge Coss-Bu, Stuart L. Goldstein

Published in: Intensive Care Medicine | Issue 4/2009

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Abstract

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.
Appendix
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Metadata
Title
Continuous renal replacement therapy amino acid, trace metal and folate clearance in critically ill children
Authors
Michael Zappitelli
Marisa Juarez
L. Castillo
Jorge Coss-Bu
Stuart L. Goldstein
Publication date
01-04-2009
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 4/2009
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-009-1420-9

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