Micronutrient loss in renal replacement therapy for acute kidney injury

W Oh,M Rigby,B Mafrici,R Mahajan,S Welham,D Harvey,A Sharman,D Gardner,M Devonald

doi:10.1186/cc14380

Abstract

The prevalence of malnutrition in acute kidney injury (AKI) is high. Patients with AKI may require renal replacement therapy (RRT), which could result in loss of water-soluble micronutrients. Little is known about these losses in RRT and whether they differ between types of RRT. This study aims to quantify micronutrient losses during RRT in patients with AKI and to compare them in three different RRT modalities: continuous venovenous haemofiltration (CVVH), intermittent haemodialysis (IHD) and sustained low-efficiency diafiltration (SLEDf).

Highlights

To assess cerebral hemodynamics in an experimental sepsis model
Healthy bowel function is an important factor when judging the advisability of early enteral nutrition in critically ill patients
Since the Surviving Sepsis Campaign (SSC) in 2002, the Health Service Ombudsman for England published recommendations for improving recognition and treatment of sepsis [2], the Royal College of Physicians issued a toolkit for the management of sepsis in the acute medical unit [3], and NHS England released a patient safety alert to support prompt recognition and treatment of sepsis [4]

Summary

Introduction

We evaluated platelet activation markers as potential predictive markers of sepsis and of mortality among four commonly encountered populations of patients admitted to ICUs. Methods Ninety-nine non-infected ICU patients were prospectively screened at day 1 (T1) and day 3 (T2) of admission after elective cardiac surgery, trauma, acute neurologic dysfunction or prolonged ventilation (>48 hours). The present study was performed with the aim of assessing whether nursing and physician staff were able to identify patients in need of critical care using only clinical judgment and to compare this with the National Early Warning Score (NEWS) Methods This was a prospective cohort study of all adult patients with a first-time admission to a medical admission unit at a 450-bed regional teaching hospital over a 3-month period in 2010.

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