100 Translational Medicine associated with Calcium Chloride/Dextrose/Lactic Acid/Magnesium Chloride/Potassium Chloride/Sodium Bicarbonate/Sodium Chloride

100 Patents (Medical) associated with Calcium Chloride/Dextrose/Lactic Acid/Magnesium Chloride/Potassium Chloride/Sodium Bicarbonate/Sodium Chloride

Literatures (Medical) associated with Calcium Chloride/Dextrose/Lactic Acid/Magnesium Chloride/Potassium Chloride/Sodium Bicarbonate/Sodium Chloride

01 Oct 2022·Clinical NephrologyQ4 · MEDICINE

CRRT-associated ketoacidosis: A series of 5 cases

Q4 · MEDICINE

Article

Author: Khanin, Yuriy ; Barnett, Richard ; Parikh, Rushang ; Wanchoo, Rimda ; Sharma, Purva

Continuous renal replacement therapy (CRRT) is a dialysis modality used in critically ill patients with acute kidney injury (AKI). Although most dialysate and replacement fluids are dextrose-containing, CRRT-associated hypophosphatemia sometimes warrants the use of phosphorus-containing solutions which are dextrose free. The other less commonly used dextrose-free dialysate solutions are certain formulations of Prismasol and Prismasate. As glucose is a small molecule, which is readily cleared with dialysis, use of these solutions can result in increased caloric loss, net glucose deficit, and shifting of the metabolic pathway towards gluconeogenesis and ketogenesis. Starvation ketosis is usually a benign entity, however when combined with factors such as stress of critical illness, can produce metabolic acidosis which at times can be severe. We describe five patients who developed worsening metabolic acidosis despite adequate clearance from CRRT and were diagnosed with CRRT-associated ketoacidosis. Administration of dextrose-containing fluids or tube feeds promptly resulted in resolution of ketonemia and acidosis. Recognition of this entity is of great importance as the reflexive reaction to increase the prescribed dose of CRRT to improve the acidosis, in fact worsens the problem.

01 Nov 2021·The International Journal of Artificial OrgansQ4 · ENGINEERING & TECHNOLOGY

Impact of different hemodiafiltration solutions on ionemia in long-term CRRT

Q4 · ENGINEERING & TECHNOLOGY

Article

Author: Innico, Georgie ; Garzotto, Francesco ; Calò, Lorenzo A ; Nalesso, Federico ; Cattarin, Leda ; Gobbi, Laura

Critical patients with Acute Kidney Injury (AKI) requiring renal replacement therapy are in most cases eligible only for continuous modalities where the electrolyte balance control is a critical issue. The standard solutions used for hemodiafiltration, containing potassium at 2 mmol/L and no phosphorus, determines during the extended renal replacement therapy hypokalemia and hypophosphatemia. Therefore, solutions containing potassium and phosphate in physiological concentrations were formulated to avoid electrolyte imbalances and reduce ion alterations in prolonged treatments, these solutions are not routinely used in the standard clinical practice. To avoid electrolyte imbalances, we have first introduced in our practice two different solutions and then we have retrospectively analyzed the electrolyte balance upon these two solutions in order to identity the impact of these solutions on potassium and phosphate according to our clinical practice. We retrospectively analyzed 96 patients treated with Continuous Renal Replacement Therapy (CRRT) in the intensive care units (ICU) at Padua’s University Hospital to evaluate the role on electrolyte balance of Phoxilium® and Prismasol 2® that differ in their composition and the need for electrolytes infusions. In the Phoxilium group the frequency of hypokalemia, hypophosphatemia, and the need of potassium and phosphate replacement were significantly reduced resulting in a reduction in complications, workload, and clinical risk associated with infusions of electrolytes. Our data demonstrated that the use of these two different hemodiafiltration solutions can reduce the occurrence of hypokalemia and hypophosphatemia during CRRT performing personalized treatments without the use of potassium and phosphate infusions.

01 Jul 2020·Hemodialysis InternationalQ4 · MEDICINE

Serum glucose and phosphorus concentrations during continuous renal replacement therapy using commercial replacement solutions with or without phosphorus

Q4 · MEDICINE

Article

Author: DeGrado, Jeremy R. ; Charytan, David M. ; Crowley, Kaitlin E.

AbstractIntroductionContinuous venovenous hemofiltration (CVVH) is a common practice in the intensive care unit often associated with electrolyte derangements. Recently, our institution added a phosphate dialysis solution, Phoxillum®, to our formulary as an option for CVVH fluid in addition to the bicarbonate‐based Prismasol® products available. We sought to evaluate the impact of Phoxillum in patients who required CVVH when compared to Prismasol with regard to phosphate and glucose management.MethodsThis was a single‐center, retrospective, observational cohort analysis approved by Partners Health Care System Institutional Review Board that included patients who received a minimum of 24 hours of either Prismasol 4/2.5 or Phoxillum for CVVH from February 2017 to November 2017. Phosphate and glucose levels were monitored daily while on CVVH. Prevalence of hypoglycemia (glucose <70 mg/dL), hyperglycemia (glucose >180 mg/dL), hypophosphatemia (phosphate <2.5 mg/dL), and hyperphosphatemia (phosphate >4.3 mg/dL) were collected in terms of days of occurrence while on CVVH. Oral and intravenous phosphate repletion requirements were collected for all patients.FindingsHypophosphatemia occurred more frequently while patients were receiving Prismasol as compared to Phoxillum (130 [24.9%] vs. 13 [6.2%], rate ratio [RR] 0.20 [95% confidence interval—CI = 0.10–0.42, P < 0.0001]), and consequently there was a numerically lower need for intravenous phosphorous repletion in the Phoxillum group (RR = 0.58, 95% CI [0.26, 1.30], P = 0.19]. There was a numerically higher incidence of hyperphosphatemia while patients were on Phoxillum therapy as compared to Prismasol (78 [37%] vs. 145 [27.7%], RR 1.25 [95% CI = 0.84, 1.86, P = 0.27]). There was no difference between the Phoxillum and Prismasol groups in terms of hypoglycemia or hyperglycemia. There was no notable difference in the cost found between the two therapies.DiscussionThe findings suggest that the use of Phoxillum for CVVH may be associated with decreased incidence of hypophosphatemia and a potentially decreased need for phosphate repletion in patients who require CVVH.

100 Deals associated with Calcium Chloride/Dextrose/Lactic Acid/Magnesium Chloride/Potassium Chloride/Sodium Bicarbonate/Sodium Chloride

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Indication	Country/Location	Organization	Date
Drug intoxication	US	Baxter Healthcare Corp.	25 Oct 2006
Kidney Diseases	US	Baxter Healthcare Corp.	25 Oct 2006

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