{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T04:24:34Z","timestamp":1745468674004,"version":"3.40.4"},"reference-count":0,"publisher":"S. Karger AG","issue":"4","license":[{"start":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T00:00:00Z","timestamp":1670976000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T00:00:00Z","timestamp":1670976000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Blood Purif"],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:p>Introduction: Acute kidney injury (AKI) is a common complication of severe burn injuries and contributes to morbidity and mortality. It is exacerbated in burn patients by elevated serum creatinine and pro-inflammatory cytokines, leading to immune dysregulation. Chronic renal replacement therapy is standard of care and removes cytokines to return the body to homeostasis. Continuous veno-venous hemodiafiltration (CVVHDF) is a high-filtration method to enhance cytokine clearance; we analyze a step-down approach for improved outcomes in burn patients. Methods: This study reviewed 15 burn patients at Akron Children\u2019s Hospital stratified into 2 groups: high-flow CVVHDF with step-down approach versus standard CVVHDF. A normocarbia bicarbonate-based dialysate solution and citrate anticoagulation was applied, and blood flow rate was maintained greater than 200 mL\/min. Results: Fifteen burn patients at Akron Children\u2019s Hospital were separated into groups managed with high-flow CVVHDF (n = 9) and standard-flow CVVHDF (n = 6). All 15 developed AKI symptoms and diuretic-resistant fluid overload, with 4\/15 displaying fluid overload greater than 40%. The most common indication for hemofiltration was acute tubular necrosis (11\/15). Average time on CVVHDF was 20.2 days and length of admission was 58.6 days. Vasodepressor dependency index was significantly reduced in the high-flow group at 48 h, but no significant difference in mortality was identified. No significant difference was identified in adverse reactions, notably electrolyte imbalances. Conclusion: The literature on the efficacy of high-flow CVVHDF is limited. This study suggests improved mortality rates and length of stay with high flow compared to the literature. Further studies with multicenter involvement are necessary. <\/jats:p>","DOI":"10.1159\/000527681","type":"journal-article","created":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T22:00:32Z","timestamp":1671055232000},"page":"341-344","source":"Crossref","is-referenced-by-count":0,"title":["High-Volume Hemodiafiltration with Step-Down Approach versus Standard-of-Care Continuous Renal Replacement Therapy Approach in Critically Ill Burn Patients"],"prefix":"10.1159","volume":"52","author":[{"given":"Anjay","family":"Khandelwal","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keval","family":"Yerigeri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Lou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rupesh","family":"Raina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2022,12,14]]},"container-title":["Blood Purification"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/bpu\/article-pdf\/52\/4\/341\/3963696\/000527681.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/bpu\/article-pdf\/52\/4\/341\/3963696\/000527681.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T15:29:49Z","timestamp":1745422189000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000527681"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,14]]},"references-count":0,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4,24]]},"published-print":{"date-parts":[[2023,5,2]]}},"URL":"https:\/\/doi.org\/10.1159\/000527681","archive":["Portico"],"relation":{},"ISSN":["0253-5068","1421-9735"],"issn-type":[{"type":"print","value":"0253-5068"},{"type":"electronic","value":"1421-9735"}],"subject":[],"published":{"date-parts":[[2022,12,14]]}}}