Shin-Yi Lin, Li-Jiuan Shen, Vin-Cent Wu, Wen-Je Ko, Chien-Chih Wu, Fe-Lin Lin Wu
BACKGROUND/PURPOSE: The pharmacokinetics of vancomycin in patients who undergo sustained low efficiency daily diafiltration (SLEDD-f) is not clear. This study aimed to determine the appropriate vancomycin dosage regimen for patients receiving SLEDD-f. METHODS: This prospectively observational study enrolled critically ill patients older than 18 years old that used SLEDD-f as renal replacement therapy and received vancomycin treatment. An 8-h SLEDD-f was performed with FX-60 (high-flux helixone membrane, 1...
August 25, 2020: Journal of the Formosan Medical Association
Hanno Bunz, Otto Tschritter, Michael Haap, Reimer Riessen, Nils Heyne, Ferruh Artunc
BACKGROUND: In patients with renal failure, gadolinium-based contrast agents (GBCA) can be removed by intermittent hemodialysis (iHD) to prevent possible toxic effects. There is no data on the efficacy of GBCA removal via sustained low efficiency daily dialysis (SLEDD) which is mainly used in intensive care unit (ICU) patients. METHODS: We compared the elimination of the GBCA gadobutrol in 6 ICU patients treated with SLEDD (6-12 h, 90 L dialysate) with 7 normal ward inpatients treated with iHD (4 h, dialysate flow 500 mL/min)...
November 21, 2019: Kidney & Blood Pressure Research
Nida Fathima, Tooba Kashif, Rajesh Naidu Janapala, Joseph S Jayaraj, Aisha Qaseem
Critically ill patients often develop multiorgan dysfunction syndrome. Acute kidney injury (AKI) is part of it. Renal replacement therapy (RRT) remains the primary choice of treatment in severely ill patients who develop AKI. Recent data have shown increased use of RRT in AKI patients. Therefore, the right choice of RRT plays an important role in the renal recovery of such patients. The question of which mode of RRT to apply has been the topic of study in the last two decades. Whether RRT should be conducted in intermittent mode, as intermittent hemodialysis (IHD), or in continuous mode, as continuous renal replacement therapy (CRRT), is still being investigated...
September 3, 2019: Curēus
James Walker Wiggins, Natalie Kozyrev, Jonathan E Sledd, George G Wilson, Lique M Coolen
Spinal cord injury (SCI) causes sexual dysfunction including anejaculation in men. Likewise, chronic mid-thoracic contusion injury impairs ejaculatory reflexes in male rats. Ejaculation is controlled by a spinal ejaculation generator (SEG) comprised of a population of lumbar spinothalamic (LSt) neurons. LSt neurons co-express four neuropeptides, including gastrin releasing peptide (GRP) and galanin and control ejaculation via release of these peptides in lumbar and sacral autonomic and motor nuclei. Here, we tested the hypothesis that contusion injury causes a disruption of the neuropeptides that are expressed in LSt cell bodies and axon terminals, thereby causing ejaculatory dysfunction...
May 21, 2019: Journal of Neurotrauma
Sidharth Kumar Sethi, Shyam B Bansal, Anshika Khare, Maninder Dhaliwal, Veena Raghunathan, Nikita Wadhwani, Ashish Nandwani, Dinesh Kumar Yadav, Amit Kumar Mahapatra, Rupesh Raina
BACKGROUND: In critically sick adults, sustained low efficiency dialysis [SLED] appears to be better tolerated hemodynamically and outcomes seem to be comparable to CRRT. However, there is paucity of data in critically sick children. In children, two recent studies from Taiwan (n = 11) and India (n = 68) showed benefits of SLED in critically sick children. AIMS AND OBJECTIVES: The objective of the study was to look at the feasibility and tolerability of sustained low efficiency daily dialysis-filtration [SLEDD-f] in critically sick pediatric patients...
2018: PloS One
Jane Sledd, David Wu, Richard Ahrens, Jeebong Lee, Lisa Waggoner, Ying Ting Tsai, Yui-Hsi Wang, Simon P Hogan
Clinical and experimental evidence indicate that polymorphisms within the interleukin 4 (IL-4) receptor (IL-4R) chain are sufficient for altered strength of IL-4/IL-13 signaling, leading to an exaggerated allergic inflammatory response and increase susceptibility to allergic phenotypes. In the present study, we show that ablation of IL-4Rα-induced phosphatidylinositol 3-kinase (PI3K) activating signal by germline point mutation within the IL-4Rα motif (Y500F) did not alter susceptibility to IgE-mediated, food-induced experimental anaphylaxis...
December 2015: Immunity, Inflammation and Disease
Xinghua Chen, Te'an Ma
OBJECTIVE: To investigate the efficacy, safety and cost of treating patients with acute kidney injury (AKI) and diabetic nephropathy (DN) with continuous renal replacement therapy (CRRT) or sustained low-efficiency daily diafiltration with hemofiltration (SLEDD-f). SUBJECTS AND METHODS: Medical records of patients with AKI/DN from January 2006 to December 2012 were reviewed. Fifty-five patients who received CRRT and 52 who received SLEDD-f were included in the study...
2014: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
Smitha Bhat, Amith D'Souza, Divya Fernandes, Gautam Rajan
An adult male labourer, a smoker and alcoholic was admitted to our hospital with a short history of fever, myalgia, breathlessness and oliguria. On examination he was icteric and hypotensive. Calf muscle tenderness was present. A provisional diagnosis of leptospirosis was made and he was started on treatment with crystalline penicillin. Blood pressure (BP) did not improve with fluids. Inotropes were started. The patient was taken for Slow Low Efficiency Daily Dialysis (SLEDD) during which he developed chest pain...
January 28, 2013: BMJ Case Reports
Nils Heyne, Martina Guthoff, Julia Krieger, Michael Haap, Hans-Ulrich Häring
BACKGROUND/AIM: Rhabdomyolysis is associated with the release of myoglobin into the circulation, promoting acute kidney injury (AKI). In severe rhabdomyolysis, dialysis-dependent AKI doubles mortality. Standard blood purification techniques have limited efficacy in removing myoglobin. We describe high cut-off (HCO) renal replacement therapy (RRT) as a novel approach for extracorporeal elimination of myoglobin in rhabdomyolysis-associated AKI. METHODS: With an in vivo molecular cut-off at 45 kDa, HCO filters are effective in removing myoglobin (17...
2012: Nephron. Clinical Practice
Inneke De Laet, Dries Deeren, Karen Schoonheydt, Niels Van Regenmortel, Hilde Dits, Manu Lng Malbrain
BACKGROUND: Little is known about the effects of renal replacement therapy (RRT) with fluid removal on intra-abdominal pressure (IAP). The global end-diastolic volume index (GEDVI) and extravascular lung water index (EVLWI) can easily be measured bedside by transpulmonary thermodilution (TPTD). The aim of this study is to evaluate the changes in IAP, GEDVI and EVLWI in critically ill patients receiving slow extended daily dialysis (SLEDD) or continuous venovenous haemofiltration (CVVH) with the intention of net fluid removal...
December 20, 2012: Annals of Intensive Care
Chia-Ying Lee, Huang-Chieh Yeh, Ching-Yuang Lin
BACKGROUND: Continuous renal replacement therapy (CRRT) and intermittent hemodialysis (IHD) offer diverse benefits and drawbacks for critically ill children with acute kidney injury (AKI). Sustained low-efficiency daily diafiltration (SLEDD-f) involves a conceptual and technical hybrid of CRRT and IHD. We report our SLEDD-f application to critically ill children in the pediatric intensive care unit (PICU). METHODS: SLEDD-f was delivered by the new Fresenius 5008 therapy system with blood flow 5 ml/kg/min, dialysate flow 260 ml/min, hemofiltration 35 ml/kg/h for 8-10 h daily...
December 2012: Pediatric Nephrology
Bruce Bergstrom, Alejandro Aguirre, Jamie Sledd
No abstract text is available yet for this article.
March 2012: Northwest Dentistry
Ranistha Ratanarat, Thunyarat Chaipruckmalakarn, Nopparat Laowahutanont, Nuttasith Larpparisuth, Somkiat Vasuvattakul
BACKGROUND: Acute kidney injury (AKI) is frequently part of a multiple-organ dysfunction syndrome presenting in critically ill patients. Prolonged intermittent renal replacement therapy (PIRRT) provides the advantages of both continuous renal replacement therapy (CRRT) in term of hemodynamic stability and the cost-effectiveness of intermittent hemodialysis (IHD). This study aims to study PIRRT in the aspects of efficacy and hemodynamic outcomes. MATERIAL AND METHOD: The authors present a single-center experience accumulated over 20 months from February 2009 to September 2010 with two PIRRT techniques, called SLEDD and SLEDD-f...
February 2012: Journal of the Medical Association of Thailand
Laura V Tsu, William E Dager
BACKGROUND: While not approved by the Food and Drug Administration for treatment of heparin-induced thrombocytopenia (HIT), except in patients undergoing percutaneous interventions, the direct thrombin inhibitor bivalirudin is a treatment option that is gaining use. An initial dose of bivalirudin 0.15-0.2 mg/kg/h, adjusted to an activated partial thromboplastin time (aPTT) of 1.5-2.5 times the baseline value, has been suggested. Initial dosing in patients with renal dysfunction, including those on hemodialysis, is unclear...
October 2011: Annals of Pharmacotherapy
Justin M Devoge, Ellen J Bass, Richard M D Sledd, Stephen M Borowitz, Linda Waggoner-Fountain
Physician sign-out is a mechanism for transferring patient information from one group of hospital care-givers to another at shift changes. Support tools are critical to the success of sign-out. To ensure that a tool is effective, designers must collaborate with end users, but collaboration can be difficult when working with users who are busy and have irregular schedules. In this article, we report on a collaborative effort between physicians and engineers to redesign a sign-out support tool. Strategies included focus groups, interviews, "on-the-fly" feedback, and an iterative design process, which engaged end users in the design process...
January 1, 2009: Ergonomics in Design: the Magazine of Human Factors Applications
Chia-Lin Wu, Ping-Fang Chiu, Yu Yang, Yao-Ko Wen, Chun-Ching Chiu, Chia-Chu Chang
Over the past decade, star fruit (Averrhoa carambola) intoxication decreased in the Taiwanese society due to improved public education on chronic kidney disease (CKD). Various complications including hiccups, altered levels of consciousness, coma, and seizures have been reported in individuals with renal failure who ingested fresh star fruit or star fruit juice. A high mortality rate (from 33 to 80%) was observed in patients with altered levels of consciousness, despite prompt dialysis and supportive care. According to previous case reports, the proposed treatment of choice for severe star fruit intoxication may be continuous renal replacement therapy with or without hemoperfusion...
2011: Renal Failure
Pamela Reed Gibson, Lauren G Sledd, William H McEnroe, Abby P Vos
This paper describes a qualitative interview study of 26 persons with multiple chemical sensitivity (MCS), also referred to as chemical intolerance. We used a phenomenological perspective and planned to focus on the impact of MCS on relationships, but found that difficulty with accessing safe spaces at times prevented relationships by limiting access to personal interactions. Thus, persons with MCS either lost or were unable to cultivate new relationships as a result of lack of spatial access. Others' lack of understanding and refusal to make accommodations at times denied spatial access to those with MCS...
September 2011: Nursing & Health Sciences
Malgorzata Debowska, Bengt Lindholm, Jacek Waniewski
Many aspects of the management of renal replacement therapy in acute renal failure (ARF), including the appropriate assessment of dialysis adequacy, remain unresolved, because ARF patients often are not in a metabolic steady state. The aim of this study was to evaluate a system of adequacy indices for dialysis in ARF patients using urea and creatinine kinetic modeling. Kinetic modeling was performed for two different fictitious patients (A and B) with characteristics described by the average parameters for two patient groups and for two blood purification treatments: sustained low efficiency daily dialysis (SLEDD) in Patient A and continuous venovenous hemofiltration (CVVH) in Patient B, based on data from a clinical report...
May 2010: Artificial Organs
David M Mushatt, Linda B Mihm, Albert W Dreisbach, Eric E Simon
Slow extended daily dialysis (SLEDD) is the newest form of dialysis that is being used increasingly to replace continuous venovenous hemodialysis (CVVHD) for critically ill patients; it is less expensive to administer and has similar safety for patients who are prone to hemodynamic instability. Unfortunately, there are limited data regarding the appropriate dosing of antimicrobial agents for patients undergoing SLEDD. Furthermore, many nonnephrologists are not familiar with the differences between SLEDD, other continuous renal replacement therapies--for example, CVVHD--and routine hemodialysis...
August 1, 2009: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
C G Georges, M Guthoff, M Wehrmann, R Teichmann, E Gröne, F Artunc, T Risler, B Friedrich, K Müssig
Hypercalcaemic crisis is a rare endocrine emergency. Often, an acute renal failure develops due to hypercalcaemia-induced polyuria. The molecular causes comprise stimulation of the calcium-sensing receptor in the ascending Henle loop and a reduced aquaporin expression in the collecting ducts. We report on a 54-year-old woman who was admitted for hypercalcaemic crisis and acute renal failure. Immediate rehydratation, bisphosphonate administration, and slow-extended daily dialysis (SLEDD) were initiated leading to a marked reduction of serum calcium...
2008: Deutsche Medizinische Wochenschrift
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