A pilot randomised controlled comparison of continuous veno–venous haemofiltration and extended daily dialysis with filtration: effect on small solutes and acid–base balance

Baldwin, Ian; Naka, Tetsuji; Koch, Bill; Fealy, Nigel; Bellomo, Rinaldo

doi:10.1007/s00134-007-0596-0

Cited by 50 publications

(25 citation statements)

References 20 publications

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“…86 While outcome studies are limited, continuous dialysis modalities consistently show improved resolution of acidosis of various types when compared to intermittent modalities. 87,88 As described above, this is related to base administration and is not a surprising finding. There are no studies comparing RRT and medical therapy with respect to clinical outcomes in patients with LA.…”

Section: Treatment Of La By Renal Replacement Therapymentioning

confidence: 66%

Treatment of lactic acidosis: Appropriate confusion

Rachoin

Weisberg

McFadden

2010

Journal of Hospital Medicine

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Lactic acid is a marker of tissue ischemia but it also may accumulate without tissue hypoperfusion. In the latter circumstance, lactic acid accumulation may be an adaptive mechanism-a novel possibility quite in contrast to the traditional view of lactic acid as only a marker of tissue ischemia. Studies on the treatment of LA with sodium bicarbonate or other buffers fail to show consistent clinical benefit. Severe acidemia in the setting of LA is a particularly poorly studied area. In the settings of medication-induced LA, optimal treatment, apart from prompt cessation of the offending agent, is still unclear.

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Section: Treatment Of La By Renal Replacement Therapymentioning

confidence: 66%

Treatment of lactic acidosis: Appropriate confusion

Rachoin

Weisberg

McFadden

2010

Journal of Hospital Medicine

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“…Accordingly, CVVH achieves better acid-base balance and electrolyte removal than extended daily dialysis, but can also induce severe hypophosphatemia [ 18 ]. The big challenge for the industry is to provide fl uids as close as possible to the plasma composition [ 15 , 17 ].…”

Section: Intermittent Versus Continuousmentioning

confidence: 99%

Metabolic Aspects of CRRT

Straaten

Chua

Joannès-Boyau

et al. 2015

Acute Nephrology for the Critical Care Physician

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Acidosis is common in patients with AKI in the ICU and often associated with acidemia. It is typically secondary to the accumulation of lactate, chloride and unmeasured anions. Its correction appears desirable and can be more reliably and safely achieved with CRRT. Use of bicarbonate-based fl uids is safest as the initial approach. However, lactate-and citrate-buffered fl uids can also correct acidosis if appropriately metabolized by the liver and other key organs. CRRT can also be used to correct extreme acidosis in the absence of a major degree of renal impairment. As

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“…To quantitatively describe the metabolic acidosis of critically ill patients, the physicochemical approach has been extensively used in the current literature [2,7,[9][10][11]. In this review of septic syndromes and metabolic acidosis, we will discuss distinct approaches to acid-base metabolism, the sources of metabolic acidosis in septic patients, associated outcomes and organ dysfunction, effects on hemodynamics, renal physiology and release of inflammatory mediators, and general aspects of clinical management.…”

Section: Introductionmentioning

confidence: 99%

Metabolic Acidosis in Sepsis

Maciel¹,

Noritomi²,

Park³

2010

EMIDDT

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Metabolic acidosis is very common in critically ill septic patients. Acidosis may be a result of the underlying pathophysiology, but it also may be the result of the way in which those patients are managed. Chloride-associated acidosis is frequent and is potentially aggravated during fluid resuscitation. The severity of metabolic acidosis is associated with poor clinical outcomes; however, it remains uncertain whether or not there is a causal relationship between acidosis and the pathophysiology of septic syndromes. Several experimental findings have demonstrated the impact of acidosis modulation on the release of inflammatory mediators and cardiovascular function. Treatment of metabolic acidosis is based on control of the underlying process and support of organ dysfunction, although the use of intravenous chloride-poor balanced solutions seems an attractive option to prevent the worsening of metabolic acidosis during fluid resuscitation.

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A pilot randomised controlled comparison of continuous veno–venous haemofiltration and extended daily dialysis with filtration: effect on small solutes and acid–base balance

Abstract: CVVH and EDDf as prescribed achieved similar control of urea, creatinine and electrolytes. Acidosis was better controlled with CVVH.

Cited by 50 publications

References 20 publications

Treatment of lactic acidosis: Appropriate confusion

Treatment of lactic acidosis: Appropriate confusion

Metabolic Aspects of CRRT

Metabolic Acidosis in Sepsis

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