Amino acid losses during continuous high-flux hemofiltration in the critically ill patient

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Abstract
Total amino acid losses were measured daily in the ultrafiltrate collected from eight patients with acute renal failure treated by continuous high-flux venovenous hemofiltration. All patients had type-1 respiratory failure and required mechanical ventilation. Four patients also suffered cardiogenic shock and were dependent on two or more inotropic drugs; the other four had Escherichia coli septicemia. All patients received identical daily parenteral nutrition as a continuous infusion. The overall mean serum amino acid values were greater in the group with cardiogenic shock (180 .+-. 36 [SEM] .mu.mol/L) compared to those with septicemia (131 .+-. 26 .mu.mol/L; p < .05). The daily ultrafiltrate losses of amino acids were also greater, 4.2 .+-. 0.7 mmol/24 h (1.1 g N) compared to 2.1 .+-. 0.3 mmol/24 h (0.6 g N, p < .05). For all patients there was a positive correlation between the serum amino acid value and ultrafiltrate loss (r = .84, p < .001). However, the slopes of the regression curves for the two groups differed (p < .001), suggesting that for the same plasma value the ultrafiltrate loss was greater for those patients with cardiogenic shock.

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