Treatment of hyperammonemia using in-line renal replacement and hyperosmolar therapies within an extracorporeal membrane oxygenation circuit.
After orthotopic lung transplantation, hyperammonemia can be a rare complication secondary to infection by organisms that produce urease or inhibit the urea cycle. This can cause neurotoxicity, cerebral edema, and seizures. Ammonia is unique in that it has a large volume of distribution. However, it...
| Publicado en: | Perfusion Vol. 38; no. 1; pp. 193 - 197 |
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| Autores principales: | , , , , , |
| Formato: | case study diagnostic images tables/charts Journal Article |
| Publicado: |
Sage Publications, Ltd.
Jan2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=161309025&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 161309025 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02676591 31J jtl: Perfusion issn: 02676591 maglogo: N pubinfo: dt: Jan2023 vid: 38 iid: 1 pid: 33180 pub: Sage Publications, Ltd. place: <Blank> artinfo: ui: 161309025 151642502 161309025 161309025 10.1177/02676591211035939 161309025 ppf: 193 ppct: 4 formats: tig: atl: Treatment of hyperammonemia using in-line renal replacement and hyperosmolar therapies within an extracorporeal membrane oxygenation circuit. aug: au: Grazioli, Alison Podell, Jamie E Iacono, Aldo Krupnik, Alexander Sasha Madathil, Ronson J Shah, Sanjeev R affil: Department of Medicine, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA sug: subj: Metabolic Diseases Therapy Renal Replacement Therapy Methods Osmolar Concentration Extracorporeal Membrane Oxygenation Lung Transplantation Postoperative Complications Metabolic Diseases Risk Factors Treatment Outcomes Human Hemodialysis Hemofiltration Seizures Aged Male Head Radiography Tomography, X-Ray Computed Hemodynamics Vasoconstrictor Agents Aged: 65+ years Male ab: After orthotopic lung transplantation, hyperammonemia can be a rare complication secondary to infection by organisms that produce urease or inhibit the urea cycle. This can cause neurotoxicity, cerebral edema, and seizures. Ammonia is unique in that it has a large volume of distribution. However, it is also readily dialyzable given its small molecular weight. As such, removal of ammonia requires renal replacement modalities that can both rapidly remove ammonia from the plasma space and allow for continuous removal to prevent rebound accumulation from intracellular stores. Prevention of iatrogenic osmotic lowering in this setting is required to prevent worsening of cerebral edema. Herein, we describe use of sequential in-line renal replacement therapy using both intermittent hemodialysis and continuous venovenous hemofiltration within an extracorporeal membrane oxygenation circuit in conjunction with higher sodium dialysate and 7.5% hypertonic saline to achieve these treatment goals. pubtype: Academic Journal doctype: case study diagnostic images tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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