442

Abstract

number of questions remain. We hypothesized that CRRT may precipitate a form of thrombocytopenia. In trials thrombocytopenia occurred at rates as high as 70%. The etiology remains unknown and results in additional diagnostic workup, and possibly drug therapy. The extent, duration, and temporal relation of thrombocytopenia remains to be determined. Methods: A retrospective study was conducted in patients receiving CRRT for > 24 hrs with no pre-existing diagnosis or cause of thrombocytopenia. Patients were evaluated to determine the influence of CRRT on platelet counts. Patients initiated on CRRT had daily platelet counts monitored, and CRRT attributes and therapeutic interventions where collected. Platelets were assessed for time to nadir, degree of decline, and time to return to baseline after discontinuation of CRRT. Results: A total of 49 patients met inclusion criteria with a male predominance and average age of 60.Most patients required CRRT for acute kidney injury. There was a mean decline in platelets of 48% with a mean of 4.6 days to the nadir. An average 2.5 days was observed until counts rose back to baseline or >150 K. This drop resulted in 37% of patients being tested for heparin induced thrombocytopenia (HIT), of which 0% had a positive test; in 44% of these patients suspicion was high enough to justify initiating therapy. Statistical analysis failed to identify any patient attributes correlated with the probability of thrombocytopenia. Conclusions: CRRT appears to be associated with a precipitous drop in platelet counts within the first 5 days of therapy with an average decline of 48%. However, platelets appear to return to > 150K (or baseline) after cessation of CRRT. This fluctuation should be considered in the setting of patients developing thrombocytopenia after initiated on CRRT.Learning Objectives: Epidemiological estimates suggest that the incidence of leukemias has steadily increased in children. Although, the current 5-year overall survival rate for ALL, the most common type of childhood leukemia, is estimated to be greater than 85%, the need for cardiopulmonary resuscitation(CPR) is associated with increased morbidity and mortality. Current national prevalence estimates and associated outcomes of CPR in children hospitalized with leukemia are unknown. We conducted this tudy to estimate the prevalence of CPR in children hospitalized due to leukemias and to examine the risk factors associated with having a CPR. Methods: We performed a retrospective analysis of the Nationwide Inpatient Sample, the largest all payer in-patient discharge dataset in United States, for the years 2004 to 2010. All patients (age up to 17 years) hospitalized primarily due to any of the leukemias (using ICD 9 CM codes) were selected. Performance of CPR in this cohort was examined. The simultaneous association of multiple patient level factors on odds of having a CPR was examined by multivariable logistic regression model. Results: A total of 48,945 children were hospitalized primarily due to leukemias. This cohort inc...