P0222 / #508: INCIDENCE OF METABOLIC DISTURBANCES DURING CONTINUOUS RENAL REPLACEMENT THERAPY WITH REGIONAL CITRATE ANTICOAGULATION
Bibliographic record
Abstract
Aims & Objectives: The objective of this study was to evaluate the incidence of electrolyt and acid-base disturbances in critically ill children undergiong continuous renal replacement therapy (CRRT) with regional citrate anticoagulation (RCA). Methods: A retrospective analysis were performed in all children treated with CRRT and RCA at a PICU in a tertiary care children´s hospital over a five year period (2015-2019). RCA was performed according to our local protocoll. We defined mild and severe disturbances for sodium, potassium, magnesium, phosphate, calcium, bicarbonate and lactate as well as metabolic acidosis and alkalosis and recorded the events per patient. Results: A total of 35 patients with a median (range) age of 5.75 years (0.1-17) were analyzed. Median duration of CRRT was 144 hours (14.7-797.2) and median filter life was 39 hours (14.7-165). Overall survival from ICU was 66% (23/35). The most common metabolic derangements were mild hypophosphatemia (n = 456 episodes, in 86 % of the patients), mild hypermagnesemia (n = 444, 86 %), mild hyperbicarbonatemia (n = 415, 76 %) and mild hypokalemia (n = 345, 95 %). Severe hypophosphatemia (n = 124, 67 %), severe hyperbicarbonatemia (n = 89, 48 %), severe ionized hypocalcemia (n = 27, 43 %) and severe metabolic alkalosis (n = 16, 29 %) were less frequent. A total 37 episodes of suspected citrate-accumulation (ratio total-Ca2+/iCa2+ > 2.5) were detected. Conclusions: Metabolic disturbances during CRRT with RCA are common and mostly mild in nature. A strict protocol with rigorous monitoring is mandatory to ensure patient safety during CRRT with RCA.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".