Experience of a Single Romanian Center on CRRT
Bibliographic record
Abstract
Daily or intermittent hemodialysis in ARF is, in general, efficient, but the procedure has various complications due to associated comorbidities and unphysiological ways of renal substitution. The aim of the study was to establish the efficiency (hydro-electrolytic equilibrium, acido-basic equilibrium, fluid balance, evolution of renal function, patient survival) and complications (hypotension, hemorrhagic, vascular access, etc.) during CRRT. We performed CRRT in 24 pts with ARF on native kidney (n = 20) or renal transplant (n = 4). In 19 cases (M = 11, F = 8, mean age = 43.2 ± 15.7 y, BW = 49 ± 7.5 kg, mean BP = 107 ± 16.6 mmHg) we made CVVHF and in 11 cases (M = 6, F = 5, mean age = 39 ± 9.9 y, BW = 55.5 ± 5.6 kg, mean BP = 104 ± 18.8 mmHg) CVVHDF. 16pts (66.6%) have been associated severe, one or more comorbidities: MSOF in 2 pt, sepsis in 3pt, coma in 2 pts, anasarca in 6 pts (1pt hepatic cirrhosis, 1pt severe cardiac failure and 4pts nephrotic syndrome), CID in 1pt, acute pancreatitis in 3 pt, liver failure and hepato-renal syndrome in 1 pt. Mean period of CVVHF was 21.6 ± 11.3 h with a mean blood flow rate of 116.9 ± 16.4 ml/min and an ultrafiltration rate of 6.42 ± 4.6 ml/min. Creatininemia level decreased from 12.6 to 8.3 mg% and urea level decreased from 237 to 166 mg%. In CVVHDF mean period of procedure was 24.0 ± 8.5 h, mean blood flow 134 ± 15.2 ml/min and mean ultrafiltration rate 5.6 ± 2.1 ml/min. Decreased of creatininemia level was from 11.6 to 6.36 mg% and for urea level from 236 to 137 mg%. Vascular approach was by jugular vein in 15 pts, femoral vein in 6 pts, subclavia vein in 1 pt and native fistula in 2 pts. Anticoagulation was performed with UHF in 14 pts and LMWH in 9 pts. In 1 pt anticoagulation was performed by repeated washback with saline solution. Renal function was recovery completely in 8 pts (33.3%), partially in 4 pts (17.2%) and 10 pts (41.7%) goes to chronic HD. Survival rate was 100% in CVVHF and 82% in CVVVHDF (2 pts died). Complications of procedures appear in 5/24 pts (20.8%) and were represented by cardiac events (hypotension in 2 pts, arrhythmia in 1 pt), bleeding disorders (hemorrhages in 2 pts, clotting in dialyser or lines in 4 pts) and diselectrolithemias (hypophosphatemia in 2 pts). In 1 pt has been necessary to change the femoral catheter to subclavia site due to thrombosis. In conclusion, continuous renal replacement therapy is efficient and well tolerated with a low frequency of complications.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.009 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".