Journal article

Continuous renal replacement therapy and its impact on hyperammonaemia in acute liver failure

Stephen Warrillow, Caleb Fisher, Heath Tibballs, Michael Bailey, Colin McArthur, Pia Lawson-Smith, Bheemasenachar Prasad, Matthew Anstey, Bala Venkatesh, Gemma Dashwood, James Walsham, Andrew Holt, Ubbo Wiersema, David Gattas, Matthew Zoeller, Mercedes Garcia Alvarez, Rinaldo Bellomo

CRITICAL CARE AND RESUSCITATION | AUSTRALASIAN MED PUBL CO LTD | Published : 2020

Abstract

OBJECTIVE: Hyperammonaemia contributes to complications in acute liver failure (ALF) and may be treated with continuous renal replacement therapy (CRRT), but current practice is poorly understood. DESIGN: We retrospectively analysed data for baseline characteristics, ammonia concentration, CRRT use, and outcomes in a cohort of Australian and New Zealand patients with ALF. SETTING: All liver transplant ICUs across Australia and New Zealand. PARTICIPANTS: Sixty-two patients with ALF. MAIN OUTCOME MEASURES: Impact of CRRT on hyperammonaemia and patient outcomes. RESULTS: We studied 62 patients with ALF. The median initial (first 24 h) peak ammonia was 132 μmol/L (interquartile range [IQR], 91-1..

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