The P-lyte?was discontinued. The nursing staff regularly rated the use of P-lyte?as superior towards the salineTable Na+ P-lyte?0.9 saline 0.45 saline 145 154 77 K+ five.0 ??Cl?98 154 77 Mg+ three.0 ??Acetate 27 ??Gluconate 23 ??options due to: (1) convenience of use, (two) improvement of serum HPI-4 chemical information electrolyte composition (top to discontinuation of mixing many bags of replacement fluids), and (3) significantly less danger of error. The fees had been felt to be comparable, for the reason that of a lower inside the want for many electrolyte additives to the replacement fluids (and also the disposables related with this). Conclusion: Plasma-lyte?appears to become a safe, expense efficient and physiologic dialysate option that may be utilized with ease. Diffusive losses of magnesium needs to be minimized with P-lyte? Hyperglycemia is minimized because of a reduced glucose content than that located in Dianeal? The chloride load presented by isotonic dialysates must be decreased with the use of Plyte? P-lyte?is now the first-choice dialysate and replacement fluid in the Shock Trauma Center for CRRT.P179 Simplified approach of regional citrate anticoagulation for continuous extra renal epurationO Cointault*, N Kamar*, P Bories*, L Lavayssiere*, O Angles, P Guittard, L Rostaing*, M Genestal, B Cathala, D Durand* *Department of Nephrology, Dialysis and Transplantation, CHU Rangueil, 1 avenue J. Poulh , 31403 Toulouse, France; Intensive Care Unit, CHU Purpan, 1 location du docteur Baylac, 31000 Toulouse, France Background: Regional anticoagulation with trisodium citrate is definitely an successful type of anticoagulation for continuous renal replacement therapy (CRRT) for patients with higher danger of bleeding complications and/or with contraindications to heparin. On the other hand, this technique isn’t made use of presently because of the metabolic complications, requiring specialized dialysis solution. We for that reason evaluated the efficacy and safety of a simplified protocol for citrate regional anticoagulation in 22 critically ill individuals treated by continuous venovenous hemodiafiltration (CVVHD). Techniques: A.C.D-A541 (Lab. BRAUN) remedy containing 112.9 mmol/l of trisodium citrate (three.22 ) was initially delivered at 250 ml/hour (imply, 251 ?27 ml/hour) by way of the prefilter port of a COBE PRISMA with an AN-69 dialyzer, together with the price adjusted toAvailable on line http://ccforum.com/supplements/6/Smaintain a post-filter ionized calcium (iCa++) between 0.3 and 0.4 mmol/l. Plasmatic iCa++ was maintained > 1.1 mmol/l by the infusion of calcium chloride (Calcium element concentration was 45.7 mmol/l) in the imply rate of 1.82 ?0.36 mmol/hour. The blood flow rate was 100 ml/min. PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20727129 Replacement resolution (Hemosol?Solution containing, Na+ = 144 mmol/l; HCO3?= 35 mmol/l; CA++ = 1.75 mmol/l) was delivered at 1000 ml/hour. Dialysate was a modified Hemosol?Remedy (containing, Na+ = 126 mmol/l; HCO3?= 17 mmol/l; CA++ = 1.75 mmol/l) and was also delivered at 1000 ml/hour. Every single seance was scheduled for 48 hours. We assessed the serum pH, serum bicarbonate, serum and post-filter iCa++ levels every 6 hours.Benefits: Mean dialyzer survival was 39 ?11 hours (median, 41.five hours). Clotting on the dialyzer was observed in 4 circumstances (13 hours; 16 hours; 18 hours and 40 hours). CVVHD was stopped voluntarily in nine individuals, with out technical difficulties (median survival was 39 hours). The mean IGS-II score was 69 ?12. There were neither bleeding events nor coagulation parameters modifications. Serum sodium, serum pH and serum bicarbonate were equivalent just before and af.