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Effects of customized bicarbonate buffered solutions for continuous renal replacement therapies on polymorphonuclear function and viability

We have previously shown that the mixture of bicarbonate and calcium in the solutions for continuous renal replacement therapies (CRRT) leads to the formation of crystals and a decrease in the delivered dose of calcium. The aim of this study was to investigate the impact of bicarbonate/calcium and lactate/calcium solutions for CRRT on polymorphonuclear cell (PMN) viability and function. We tested four customized bicarbonate buffered solutions: the single bag (bicarbonate and calcium mixed 24 hours before testing), the double bag (mixed immediately before), and the filtered single bag and double bag solutions. We also tested one commercial lactate buffered solution. Blood from six volunteers was incubated with the test solution for 30 min followed by PMN isolation. Isolated PMNs were resuspended in 50% RPMI + 50% autologous serum and kept overnight. Viability, necrosis and apoptosis were analyzed by annexin V and PI staining. Phagocytosis was determined by the analysis of Staphylococcus aureus-PI stained PMN and ROS production by the mean fluorescence intensity of DCFH in these cells. There was no difference between the test solutions with respect to PMN viability and function. Lactate and bicarbonate had similar effects on PMN viability and function. More studies are mandatory to elucidate the impact of CRRT solutions on other inflammatory cells and pathways, particularly on the cytokines associated with systemic inflammatory response syndrome and sepsis.

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Maccariello, E., Rocha, E., Dalboni, M. et al. Effects of customized bicarbonate buffered solutions for continuous renal replacement therapies on polymorphonuclear function and viability. Crit Care 7 (Suppl 3), P43 (2003). https://doi.org/10.1186/cc2239

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  • DOI: https://doi.org/10.1186/cc2239

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