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Title: Myoglobin clearance by super high-flux hemofiltration in a case of severe rhabdomyolysis: a case report.
Austin Authors: Naka, Toshio;Jones, Daryl A ;Baldwin, Ian C ;Fealy, Nigel G ;Bates, Samantha;Goehl, Hermann;Morgera, Stanislao;Neumayer, Hans H;Bellomo, Rinaldo 
Affiliation: Department of Intensive Care, Melbourne University, Austin Hospital, Melbourne, Australia
Issue Date: 21-Jan-2005
Publication information: Critical Care 2005; 9(2): R90-5
Abstract: To test the ability of a novel super high-flux (SHF) membrane with a larger pore size to clear myoglobin from serum.The intensive care unit of a university teaching hospital.A patient with serotonin syndrome complicated by severe rhabodomyolysis and oliguric acute renal failure.Initially continuous veno-venous hemofiltration was performed at 2 l/hour ultrafiltration (UF) with a standard polysulphone 1.4 m2 membrane (cutoff point, 20 kDa), followed by continuous veno-venous hemofiltration with a SHF membrane (cutoff point, 100 kDa) at 2 l/hour UF, then at 3 l/hour UF and then at 4 l/hour UF, in an attempt to clear myoglobin.The myoglobin concentration in the ultrafiltrate at 2 l/hour exchange was at least five times greater with the SHF membrane than with the conventional membrane (>100,000 microg/l versus 23,003 microg/l). The sieving coefficients with the SHF membrane at 3 l/hour UF and 4 l/hour UF were 72.2% and 68.8%, respectively. The amount of myoglobin removed with the conventional membrane was 1.1 g/day compared with 4.4-5.1 g/day for the SHF membrane. The SHF membrane achieved a clearance of up to 56.4 l/day, and achieved a reduction in serum myoglobin concentration from >100,000 microg/l to 16,542 microg/l in 48 hours.SHF hemofiltration achieved a much greater clearance of myoglobin than conventional hemofiltration, and it may provide a potential modality for the treatment of myoglobinuric acute renal failure.
Gov't Doc #: 15774055
DOI: 10.1186/cc3034
Journal: Critical Care
Type: Journal Article
Subjects: Acute Kidney Injury.complications
Glasgow Coma Scale
Hospitals, Teaching
Intensive Care Units
Middle Aged
Serotonin Syndrome.complications.diagnosis.therapy
Time Factors
Appears in Collections:Journal articles

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