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Colloids and anaphylactoid reactions
60 experience that led to her admission to the Intensive Care Unit or because of a baby being preterm or ill. There is little or no literature that deals with breastfeeding after the critical illness of a childbearing woman. Method: An exploratory qualitative study was undertaken in which 12 women had in-depth audio taped interviews about their experience of being hospitalised in the intensive care unit as a result of a critical illness/episode during childbirth. Findings: Four issues were identified: (1) Women felt ambivalent about breastfeeding their babies as a result of their illness and the extreme exhaustion that followed. (2) Where their birthing bodies had failed them, some felt they could be redeemed through breastfeeding. (3) Lactogenesis II (milk coming in) seemed to be later particularly in those women who have received an excess amount of fluid. (4) The separation of the woman from her baby led to poor self-confidence and self-esteem. Conclusion: Women who have had an ICU experience following the birth of their baby need more individualized, sensitive care relating to breastfeeding and need time to focus on getting to know their baby rather than just on feeding them. Skin-to skin contact of mother and baby is vital to support this. Further study is needed with regard to fluid balance and lactogenesis II for critically ill maternity women. The influence of ICU staff on these women and their infants and families is significant to ensure their future health, as is the collaborative care provided by ICU staff, midwives, neonatal staff and lactation consultants and the ongoing follow-up of the mother and her baby.
Abstracts comparison, gelatins) spontaneously reported to the Therapeutic Goods Administration’s Australian Adverse Reactions Advisory Committee (ADRAC). The reporting period examined started from late 2000, when ALBUMEX 4% 2VI supply commenced, to December 2005. The relative incidence of cases/AEs calculated was expressed as a rate per 100,000 litres of product distributed. Overall the relative incidence of total cases reported was 5—17 times more for gelatins (Haemaccel 23.5, Gelofusine 7.1) than ALBUMEX (1.4). The incidence of individual AEs reported was greater for gelatins than ALBUMEX for anaphylactoid reactions (12—39 times), hypotension (3—14 times greater), and symptoms of respiratory distress (4—9 times). This analysis of ADRAC’s colloid AE data suggests that symptoms of respiratory distress, hypotension and anaphylactoid reactions were rarely reported for ALBUMEX 4% 2VI in the period examined, and were significantly less than the gelatin colloids. These findings are not in line with those reported in an ADRAC Bulletin in 2006, which suggested such reactions were reported in similar proportions with these colloids, however this may be because their reporting period included AEs reported for past, less pure, generations of albumin products. doi:10.1016/j.aucc.2007.12.022 An audit of anticoagulation algorithms for renal replacement therapy Tania Elderkin Barwon Health, Australia
doi:10.1016/j.aucc.2007.12.021 Adult Posters Colloids and anaphylactoid reactions Fiona Wilson* , Anne-Maree Turvey, Daryl Maher CSL Bioplasma, Australia In Australia, ALBUMEX® 4% (human albumin) and the gelatin products, Gelofusine and Haemaccel (succinylated gelatin and polygeline respectively) are the main colloids used in fluid resuscitation. Medical emergencies associated with anaphylaxis, significant hypotension and/or respiratory distress have occurred occasionally following administration of such colloids. To examine the occurrence of such adverse events (AEs) with CSL Bioplasma’s most recent generation of albumin product, ALBUMEX 4% 2VI, data was obtained on the colloid AEs (albumin and, for
At least 80 patients/year undergo continuous renal replacement therapy (CRRT) in our tertiary level ICU in a regional healthcare centre. In 2004 we implemented three anticoagulation algorithms to assist in the management of CRRT circuits. The algorithms were designed collaboratively by nursing, medical and pharmacy staff to cover ‘Standard’ pre-filter heparinisation, ‘Regional’ pre-filter heparin and post-filter protamine and ‘Systemic’ heparinisation for those patients who require therapeutic anticoagulation. To monitor compliance and outcomes related to use of these algorithms, an audit of patient-related data and CRRT circuit life was undertaken using a convenience sample of 46 patients (>120 filters) over 30 months. During this time significant changes to the practice of CRRT occurred in the ICU, including changes in vascular access devices, pre-dilution to post-dilution circuits and blood, replacement fluid and dialysate flow rates.
Abstracts comparison, gelatins) spontaneously reported to the Therapeutic Goods Administration’s Australian Adverse Reactions Advisory Committee (ADRAC). The reporting period examined started from late 2000, when ALBUMEX 4% 2VI supply commenced, to December 2005. The relative incidence of cases/AEs calculated was expressed as a rate per 100,000 litres of product distributed. Overall the relative incidence of total cases reported was 5—17 times more for gelatins (Haemaccel 23.5, Gelofusine 7.1) than ALBUMEX (1.4). The incidence of individual AEs reported was greater for gelatins than ALBUMEX for anaphylactoid reactions (12—39 times), hypotension (3—14 times greater), and symptoms of respiratory distress (4—9 times). This analysis of ADRAC’s colloid AE data suggests that symptoms of respiratory distress, hypotension and anaphylactoid reactions were rarely reported for ALBUMEX 4% 2VI in the period examined, and were significantly less than the gelatin colloids. These findings are not in line with those reported in an ADRAC Bulletin in 2006, which suggested such reactions were reported in similar proportions with these colloids, however this may be because their reporting period included AEs reported for past, less pure, generations of albumin products. doi:10.1016/j.aucc.2007.12.022 An audit of anticoagulation algorithms for renal replacement therapy Tania Elderkin Barwon Health, Australia
doi:10.1016/j.aucc.2007.12.021 Adult Posters Colloids and anaphylactoid reactions Fiona Wilson* , Anne-Maree Turvey, Daryl Maher CSL Bioplasma, Australia In Australia, ALBUMEX® 4% (human albumin) and the gelatin products, Gelofusine and Haemaccel (succinylated gelatin and polygeline respectively) are the main colloids used in fluid resuscitation. Medical emergencies associated with anaphylaxis, significant hypotension and/or respiratory distress have occurred occasionally following administration of such colloids. To examine the occurrence of such adverse events (AEs) with CSL Bioplasma’s most recent generation of albumin product, ALBUMEX 4% 2VI, data was obtained on the colloid AEs (albumin and, for
At least 80 patients/year undergo continuous renal replacement therapy (CRRT) in our tertiary level ICU in a regional healthcare centre. In 2004 we implemented three anticoagulation algorithms to assist in the management of CRRT circuits. The algorithms were designed collaboratively by nursing, medical and pharmacy staff to cover ‘Standard’ pre-filter heparinisation, ‘Regional’ pre-filter heparin and post-filter protamine and ‘Systemic’ heparinisation for those patients who require therapeutic anticoagulation. To monitor compliance and outcomes related to use of these algorithms, an audit of patient-related data and CRRT circuit life was undertaken using a convenience sample of 46 patients (>120 filters) over 30 months. During this time significant changes to the practice of CRRT occurred in the ICU, including changes in vascular access devices, pre-dilution to post-dilution circuits and blood, replacement fluid and dialysate flow rates.