Abstract: TH-PO224
Troponin Clearance via Continuous Kidney Replacement Therapies in the Intensive Care Unit (ICU)
Session Information
- Hemodialysis, Hemodiafiltration, and Frequent Dialysis
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Mason, Sabina, Tallaght University Hospital, Dublin, Dublin, Ireland
- Deasy, Evelyn, Tallaght University Hospital, Dublin, Dublin, Ireland
- Donnelly, Maria, Tallaght University Hospital, Dublin, Dublin, Ireland
- D'Arcy, Deirdre M., The University of Dublin Trinity College, Dublin, Ireland
- Chevarria, Julio L., Tallaght University Hospital, Dublin, Dublin, Ireland
- Kelly, Yvelynne P., Tallaght University Hospital, Dublin, Ireland
Background
Our aim was to compare the clearance of cardiac troponin T via continuous venovenous haemofiltration (CVVH), continuous venovenous haemodialysis (CVVHD) and continuous venovenous haemodiafiltration (CVVHDF) as a function of circulating serum troponin levels in critically ill patients.
Methods
This was a single-centre, prospective observational study conducted at Tallaght University Hospital in Dublin. Adult patients admitted to ICU and commenced on continuous renal replacement therapy (CRRT) were included. All included patients required a serum troponin T level of greater than 50 ng/L. All patients were required to have commenced CRRT at least four hours before the first sample was taken. We took three serum samples per patient every 24 hours, i.e. over a total of 72 hours, with simultaneous sampling of the waste effluent of the RRT to measure effluent troponin. Our primary outcome measure was estimated troponin clearance according to CRRT modality.
Results
We found no significant difference in estimated troponin clearance according to CRRT modality; with an overall median troponin clearance of 2.6 ml/kg/hour. The percentage of troponin clearance was statistically significantly higher for CVVH compared to CVVHD and CVVHDF (17 vs 14 vs 12% respectively; p = 0.008), though this was not felt to be clinically significant.
Conclusion
In this single-centre, prospective observational study, we measured simultaneous blood and effluent troponin T levels in patients on either CVVHDF, CVVHD or CVVH to compare estimated troponin clearance between the three CRRT modalities. We found no significant difference in estimated troponin clearance according to CRRT modality. Our results show that clearance of troponin T on CRRT is generally small across all modalities and that therefore ongoing treatment with CRRT should not significantly impact our interpretation and tracking of troponin T results in patients with concern for acute coronary syndrome.
Estimated clearance and troponin clearance per CRRT modality