PD232 - CAN AMINO ACID LOSS DURING CONTINUOUS RENAL REPLACEMENT THERAPY (CRRT) BE MEASURED RELIABLY ONCE DAILY?

PD232

CAN AMINO ACID LOSS DURING CONTINUOUS RENAL REPLACEMENT THERAPY (CRRT) BE MEASURED RELIABLY ONCE DAILY?

S. Yadavalli^1,*, A. Schranz¹, N. Nantschev¹, J. Makar¹, K. Janata¹, I. Dankov¹, L. Lechner¹, A. Möller Petrun², O. Rooyackers³, M. Zeyda⁴, A. Laßnigg¹, M. Hiesmayr⁵, A. Fischer-Hammerschmied¹

¹Clinical Division of Cardiothoracic and Vascular Anesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria, ²Department of Anaesthesiology, Intensive Therapy and Pain Management, University Medical Centre Maribor, Maribor, Slovenia, ³Division of Anaesthesia and Intensive Care, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden, ⁴Department of Pediatrics and Adolescent Medicine, ⁵Center for Medical Data Science, Medical University of Vienna, Vienna, Austria

Rationale: Amino acids freely pass through the CRRT filter due to their small molecular weight. However, amino acid loss during CRRT has not been quantified throughout the entire CRRT period. The present objective was to evaluate whether a single daily measurement of amino acid effluent concentration can reliably quantify 24h amino acid effluent loss.

Methods: This ongoing observational study plans to enrol 20 intensive care unit (ICU) patients undergoing CRRT and 10 without CRRT. Included are adult ICU patients after cardiothoracic or major vascular surgery without acute liver failure. In all CRRT patients, plasma and effluent amino acid concentrations are measured once daily at CRRT start, on the first 4 CRRT days, every third day until CRRT discontinuation and 2 days post-CRRT. In the first 2 CRRT patients, effluent concentrations were measured in both the effluent tube and the full effluent bag every 4 hours over CRRT day 4 to quantify real amino acid loss in the total 24h-effluent volume. Effluent flow was set at 2000ml/h for both test patients. Amino acid concentrations in the effluent and plasma were measured using High-performance Liquid Chromatography (HPLC) fluorescence.

Results: Amino acid concentrations measured in the effluent bags every 4 hours over 24h remained stable. Within-patient changes were assessed descriptively (n=2 patients). Amino acid concentrations in effluent tube and bags were similar. We measured an amino acid loss of 13.47g in patient 1 and 8.94g in patient 2 over 24h.

Conclusion: Daily amino acid loss can be reliably estimated by measuring effluent amino acid concentration in the effluent tube. Substantial amino acid loss occurs during CRRT, which may guide amino acid supplementation during CRRT.

Disclosure of Interest: None declared