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Title: Phoxilium vs Hemosol-B0 for continuous renal replacement therapy in acute kidney injury.
Austin Authors: Chua, Horng-Ruey;Schneider, Antoine G;Baldwin, Ian C ;Collins, Allison L ;Ho, Lisa;Bellomo, Rinaldo 
Affiliation: Department of Intensive Care, Austin Hospital, Melbourne, Australia
Division of Nephrology, University Medicine Cluster, National University Hospital, National University Health System, Singapore.
Issue Date: 14-May-2013
Publication information: Journal of Critical Care 2013; 28(5): 884.e7-14
Abstract: This study aimed to compare the biochemical effects of Phoxilium (containing phosphate at 1.2 mmol/L; Gambro Lundia AB, Lund, Sweden) and Hemosol-B0 (Gambro Lundia AB) as dialysate and/or replacement fluid during continuous renal replacement therapy (CRRT).We examined serum biochemistry in critically ill patients for 42 hours of Phoxilium administration for the prevention of hypophosphatemia during CRRT and compared them with corresponding results in random historical controls who received Hemosol-B0.We studied 15 patients in each arm (Phoxilium vs Hemosol-B0). Respective median ages were 57 (49-68) and 64 (57-67) years. Baseline patient illness severity scores, prescribed CRRT effluent rates, and cumulative phosphate intakes were comparable. After 36 to 42 hours of Phoxilium administration, serum phosphate levels increased from 0.95 (0.81-1.13) to 1.44 (1.23-1.78) mmol/L, in contrast to the decline from 1.71 (1.09-2.00) to 0.83 (0.55-1.59) mmol/L with Hemosol-B0 (P=.0001). Serum ionized calcium levels decreased from 1.27 (1.22-1.37) to 1.12 (1.06-1.21) mmol/L with Phoxilium, compared with an increase from 1.09 (0.90-1.19) to 1.20 (1.16-1.25) mmol/L with Hemosol-B0 (P<.0001). Serum bicarbonate, base excess levels, and effective strong ion difference decreased with Phoxilium and were lower than those with Hemosol-B0 at 36 to 42 hours (P<.05).Phoxilium effectively prevented hypophosphatemia during CRRT but was associated with relative metabolic acidosis and hypocalcemia compared with Hemosol-B0 use.
Gov't Doc #: 23683569
DOI: 10.1016/j.jcrc.2013.02.013
Journal: Journal of Critical Care
Type: Journal Article
Subjects: Acid-base balance
Acute kidney injury
Continuous renal replacement therapy
Critical illness
Electrolyte abnormalities
Metabolic acidosis
Phosphate-containing solution
Acute Kidney Injury.therapy
Blood Substitutes.therapeutic use
Case-Control Studies
Critical Illness
Dialysis Solutions.therapeutic use
Hypophosphatemia.prevention & control
Middle Aged
Phosphates.therapeutic use
Renal Replacement Therapy.methods
Retrospective Studies
Treatment Outcome
Appears in Collections:Journal articles

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