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Objective:To investigate the clinical value of cephalosporin combined with morinidazole in the prevention of surgical site infection (SSI) for gastrointestinal fistula.Methods:The retrospective cohort study was conducted. The clinicopathological data of 107 patients with gastrointestinal fistula who undergoing selective digestive tract reconstruction surgery in General Hospital of Eastern Theater Command from January to December 2017 were collected. There were 76 males and 31 females, aged from 18 to 79 years, with a median age of 46 years. Of 107 patients, 43 cases receiving cephalosporin for prevention of SSI were allocated into cephalosporin monotherapy group, 64 cases receiving cephalosporin combined with morinidazole were allocated into combination therapy group, respectively. Observation indicators: (1) incidence of SSI; (2) stratification; (3) pathogen culture results of SSI; (4) adverse drug reaction; (5) follow-up. Follow-up using outpatient examination and telephone interview was performed to detect other complications of patients. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the independent sample t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was analyzed using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Results:(1) Incidence of SSI: 29 of 107 patients had postoperative SSI, including 15 cases with superficial SSI, 7 cases with deep SSI, and 7 cases with organ/space SSI. There were 18 cases of cephalosporin monotherapy group with SSI, including 7 cases with superficial SSI, 5 cases with deep SSI, and 6 cases with organ/space SSI. The above indicators were 11, 8, 2, 1 of combination therapy group, respectively. There was a significant difference in the overall SSI between the two groups ( χ2=7.925, P<0.05). There was also a significant difference in the organ/space SSI between the two groups ( P<0.05). There was no significant difference in the superficial SSI between the two groups ( χ2=0.305, P>0.05). There was no significant difference in the deep SSI between the two groups ( P>0.05). (2) Stratification: there were 10 cases and 33 cases with type Ⅱ incision and type Ⅲ incision in the 43 cases of cephalosporin monotherapy therapy group, respectively. The above indicators were 11 and 53 in the combination group, respectively. For the type Ⅱ incision, 1 patient of cephalosporin monotherapy group had SSI, and 2 cases of combination therapy group had SSI, showing no significant difference between the two groups ( P>0.05). For the type Ⅲ incision, 17 patient of cephalosporin monotherapy group had SSI, and 9 cases of combina-tion therapy group had SSI, showing a significant difference between the two groups ( χ2=11.499, P<0.05). (3) Pathogen culture results of SSI: of 29 patients with SSI, 21 were positive for bacterial culture, including 12 cases with single bacterial infection, 9 cases with mixed infection of multi-bacteria. A total of 33 strains were cultured. (4) Adverse drug reaction: there was no adverse drug reaction in the 107 patients. (5) Follow-up: 107 patients were followed up for 30 days after surgery. No complication occurred in the 107 patients. Conclusion:Cephalosporin combined with morini-dazole can be used to prevent the SSI for patients with gastrointestinal fistula.
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Objective:To investigate the diagnosis and treatment for intra-abdominal fistula in China, and to explore the prognostic factors.Methods:A multi-center cross-sectional study was conducted based on the Registration System of Chinese Gastrointestinal Fistula and Intra-Abdominal Infections to collect the clinical data of patients with intra-abdominal fistula from 18 medical centers from January 1, 2018 to December 31, 2018, including basic information, medical records and prognosis.Results:A total of 106 patients were enrolled in this study, including 57 males and 49 females, with an average age of (48.0±17.8)years. The most common type of intra-abdominal fistula was entero-vesical fistula (34.0%), followed by entero-vaginal fistula (31.1%), entero-enteric fistula (26.4%) and multiple fistula (8.5%). The direct causes of intra-abdominal fistula were mainly surgical operation (66.0%), followed by spontaneous fistula due to Crohn′s disease (18.9%), radiation intestinal injury (11.3%), and 4 cases (3.8%) of unknown reasons. During the whole treatment, 95 patients received nutritional support therapy, mainly EN+ PN (75.8%). Finally, 86 patients (81.1%) received surgical treatment, with a healing rate of 95.3%. After surgery, 8.1% of patients developed surgical site infections (SSI), and 10.5% had a relapse of fistula. 20 patients (18.9%) were treated conservatively, with a self-healing rate of 80.0%. The overall mortality rate was 8.5%, and the highest mortality (15.2%) was found in entero-enteric fistula. Statistical analysis showed that the age ( t=-4.664, P<0.001), leucocyte level ( U=663.000, P=0.010), sepsis ( P=0.002) and multiple organ dysfunction syndrome (MODS) ( P=0.019) were higher in the death group than those in the healing group. Multivariate analysis suggested that advanced age ( OR=1.073, 95% CI: 1.008-1.141, P=0.026) and complications of sepsis ( OR=11.806, 95% CI: 1.064-131.048, P=0.044) were independent risk factors of the death for patients with intra-abdominal fistula. Conclusions:The overall mortality rate of intra-abdominal fistula is still high, and malignant tumor is the most common primary disease. Advanced age and sepsis are independent risk factors for death in patients with intra-abdominal fistula.
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Objective@#To investigate the diagnosis and treatment for enterocutaneous fistula (ECF) in China, and to explore the prognostic factors of ECF.@*Methods@#A multi-center cross-sectional study was conducted based on the Registration System of Chinese Gastrointestinal Fistula and Intra-Abdominal Infections to collect the clinical data of ECF patients from 54 medical centers in 22 provinces/municipalities from January 1, 2018 to December 31, 2018. The clinical data included patient gender, age, length of hospital stay, intensive care unit (ICU) admission, underlying diseases, primary diseases, direct causes of ECF, location and type of ECF, complications, treatment and outcomes. All medical records were carefully filled in by the attending physicians, and then re-examined by more than two specialists. The diagnosis of ECF was based on the clinical manifestations, laboratory/imaging findings and intraoperative exploration.@*Results@#A total of 1521 patients with ECF were enrolled, including 1099 males and 422 females, with a median age of 55 years. The top three primary diseases of ECF were malignant tumors in 626 cases (41.2%, including 540 gastrointestinal tumors, accounting for 86.3% of malignant tumors), gastrointestinal ulcers and perforations in 202 cases (13.3%), and trauma in 157 cases (10.3%). The direct causes of ECF were mainly surgical operation in 1194 cases (78.5%), followed by trauma in 156 (10.3%), spontaneous fistula due to Crohn′s disease in 92 (6.0%), radiation intestinal injury in 41 (2.7%), severe pancreatitis in 20 (1.3%), endoscopic treatment in 13 (0.9%) and 5 cases (0.3%) of unknown reasons. All the patients were divided into three groups: 1350 cases (88.7%) with simple ECF, 150 (9.9%) with multiple ECF, and 21 (1.4%) with combined internal fistula. Among the patients with simple ECF, 438 cases (28.8%) were jejuno-ileal fistula, 313 (20.6%) colon fistula, 170 (11.2%) rectal fistula, 111 (7.3%) duodenal fistula, 76 (5.0%) ileocecal fistula, 65 (4.3%) ileocolic anastomotic fistula, 55 (3.6%) duodenal stump fistula, 36 (2.4%) gastrointestinal anastomotic fistula, 36 (2.4%) esophagogastric/esophagojejunal anastomotic fistula, 29 (1.9%) gastric fistula and 21 (1.4%) cholangiopancreatiointestinal. Among all the simple ECF patients, 991 were tubular fistula and 359 were labial fistula. A total of 1146 patients finished the treatment, of whom 1061 (92.6%) were healed (586 by surgery and 475 self-healing) and 85 (7.4%) died. A total of 1043 patients (91.0%) received nutritional support therapy, and 77 (6.7%) received fistuloclysis. Infectious source control procedures were applied to 1042 patients, including 711 (62.0%) with active lavage and drainage and 331 (28.9%) with passive drainage. Among them, 841 patients (73.4%) underwent minimally invasive procedures of infectious source control (replacement of drainage tube through sinus tract, puncture drainage, etc.), 201 (17.5%) underwent laparotomy drainage, while 104 (9.1%) did not undergo any drainage measures. A total of 610 patients (53.2%) received definitive operation, 24 patients died within postoperative 30-day with mortality of 3.9% (24/610), 69 (11.3%) developed surgical site infection (SSI), and 24 (3.9%) had a relapse of fistula. The highest cure rate was achieved in ileocecal fistula (100%), followed by rectal fistula (96.2%, 128/133) and duodenal stump fistula (95.7%,44/46). The highest mortality was found in combined internal fistula (3/12) and no death in ileocecal fistula. Univariate prognostic analysis showed that primary diseases as Crohn′s disease (χ2=6.570, P=0.010) and appendicitis/appendiceal abscess (P=0.012), intestinal fistula combining with internal fistula (χ2=5.460, P=0.019), multiple ECF (χ2=7.135, P=0.008), esophagogastric / esophagojejunal anastomotic fistula (χ2=9.501, P=0.002), ECF at ileocecal junction (P=0.012), non-drainage/passive drainage before the diagnosis of intestinal fistula (χ2=9.688, P=0.008), non-drainage/passive drainage after the diagnosis of intestinal fistula (χ2=9.711, P=0.008), complicating with multiple organ dysfunction syndrome (MODS) (χ2=179.699, P<0.001), sepsis (χ2=211.851, P<0.001), hemorrhage (χ2=85.300, P<0.001), pulmonary infection (χ2=60.096, P<0.001), catheter-associated infection (χ2=10.617, P=0.001) and malnutrition (χ2=21.199, P<0.001) were associated with mortality. Multivariate prognostic analysis cofirmed that sepsis (OR=7.103, 95%CI:3.694-13.657, P<0.001), complicating with MODS (OR=5.018, 95%CI:2.170-11.604, P<0.001), and hemorrhage (OR=4.703, 95%CI: 2.300-9.618, P<0.001) were independent risk factors of the death for ECF patients. Meanwhile, active lavage and drainage after the definite ECF diagnosis was the protective factor (OR=0.223, 95%CI: 0.067-0.745, P=0.015).@*Conclusions@#The overall mortality of ECF is still high. Surgical operation is the most common cause of ECF. Complications e.g. sepsis, MODS, hemorrhage, and catheter-associated infection, are the main causes of death. Active lavage and drainage is important to improve the prognosis of ECF.
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Objective To explore the predictive value of prognostic nutritional index (PNI) in surgical site infections (SSIs) for intestinal fistula patients undergoing bowel resections.Methods Clinical data of 290 gastrointestinal fistula patients who underwent intestinal resections between 2012 and 2015 were retrospectively reviewed.Univariate and multivariate analyses were conducted to identify risk factors for SSIs,and receiver operating characteristic (ROC) curve was used to quantify the effectiveness of PNI.Results SSIs were diagnosed in 99 (34.1％) patients.ROC curve analysis defined a PNI cut-off level of 45 corresponding to postoperative SSIs (area under the curve =0.72,76％ sensitivity,55％ specificity).Furthermore,a multivariate analysis indicated that the PNI ＜ 45 (OR:2.24,95％ CI:1.09-4.61,P =0.029) and preoperative leukocytosis (OR:3.70,95 ％ CI:1.02-13.42,P =0.046) were independently associated with postoperative SSIs.Conclusions Preoperative PNI is useful to predict SSIs in intestinal fistulae patients after enterectomies.
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Objective To investigate the predictive value of non-thyroidal illness syndrome (NTIS) before definitive operation on postoperative surgical site infection (SSI) in patients with enterocutaneous fistula (ECF).Methods The retrospective case-control study was conducted.The clinical data of 264 ECF patients (181 with euthyroidism and 83 with NTIS) who underwent definitive operation in the Nanjing General Hospital of Nanjing Military Command between April 2014 and November 2016 were collected.After definitive operation,86 with SSI and 178 without SSI were respectively allocated into the SSI group and non-SSI group.Observation indicators:(1) risk factor analysis of postoperative SSI;(2) effect of preoperative NTIS on postoperative SSI;(3) predictive power of serum free triiodothyronine 3 (FT3) level on postoperative SSI.Measurement data with normal distribution were represented as x-± s and was analyzed using the t test.Count data were described as absolute number or percentage,and were analyzed using the chi-square test.The comparison of ordinal data was done by the nonparamentric test.The multivariate analysis was done using the logistic regression model.The receiver operating characteristic (ROC) curve was drawn,and area under the curve (AUC) was calculated for analyzing predictive power of serum FT3 level on postoperative SSI.Results (1) Risk factor analysis of postoperative SSI:cases with volume of preoperative intestinal fluid loss through fistula stoma ＜ 200 mL/24 hours,from 200 to 500 mL/24 hours and ＞ 500 mL/24 hours,preoperative hemoglobin (Hb) level,cases with surgical site located in stomach and duodenum,small intestine,ileocolon and colorectum,cases with open surgery and laparoscopic surgery were respectively 65,15,6,(119±36)g/L,5,50,31,36,58,28 in the SSI group and 135,27,16,(125±39)g/L,11,91,53,71,127,51 in the non-SSI group,with no statistically significant difference between groups (x2 =0.471,t =1.202,x2 =0.332,0.422,P＞0.05).Cases with preoperative single.and multiple fistula stoma,serum albumin (Alb) level,cases with preoperative NTIS,volume of intraoperative blood loss ＜ 300 mL and ≥ 300 mL,operation duration ＜ 3 hours and ≥ 3 hours were respectively 57,29,(35±.8)g/L,36,67,19,53,33 in the SSI group and 146,32,(37±9)g/L,47,161,17,140,38 in the non-SSI group,with statistically significant differences between groups (x2 =8.089,t =2.422,x2 =6.426,7.746,8.547,P＜0.05).Results of multivariate analysis showed that preoperative multiple intestinal fistula and NTIS were independent factors affecting occurrence of postoperative SSI in ECF patients (odds ratio =1.873,2.464,95％ confidence interval:1.052-2.671,1.120-4.392).(2) Effect of preoperative NTIS on postoperative SSI:incidence of preoperative multiple intestinal fistula,proportion of cases with preoperative enteral nutrition time ＞3 months,incidence of postoperative SSI,postoperative superficial and deep incision infection rates and organ/space infection rate were respectively 31.3％ (26/83),72.3％ (60/83),43.4％ (36/83),9.6％ (8/83),21.7％(18/83),7.2％ (6/83) in patients with NTIS and 19.3％(35/181),57.5％(104/181),27.6％(50/181),11.6％(21/181),3.9％(7/181),8.8％ (16/181) in patients with euthyroidism,with statistically significant differences in incidence of multiple intestinal fistula,proportion of cases with preoperative enteral nutrition time ＞ 3 months,incidence of postoperative SSI,superficial and deep incision infection rates (x2 =4.603,5.319,6.426,4.256,4.377,P＜0.05),and no statistically significant difference in organ/space infection rate (x2=0.193,P＞0.05).(3) Predictive power of serum FT3 level on postoperative SSI:the ROC curve showed that optimal cut-off point of serum FT3 predicting postoperative SSI was 3.5 pmol/L,AUC,sensibility and specificity were respectively 0.75,72.6％ and 68.7％.Conclusion The presence of NTIS is associated with occurrence of postoperative SSI in patients with ECF before definitive operation,and optimal cut-off point of serum FT3 predicting postoperative SSI is 3.5 pmol/L.
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Objective:To investigate the risk factors and prognostic effects of intolerance of early enteral nutrition after surgery for gastric cancer.Methods:The clinical data of 75 patients with gastric cancer who were admitted in the Shoukang hospital and received early enteral nutrition after surgery were retrospectively retrived and analyzed.Patients were divided into the tolerance group and the non-tolerance group according to whether the patients developed the symtoms of nausea,vomiting,abdominal pain,distention and diarrhea after early enteral nutrition.Results:51 patients (68％) showed enteral nutrition intolerance after early enteral nutrition postoperatively,whereas 24 (32％) were in the tolerance group.The activity time out of bed on the first postoperative day,the time of initiation of enteral nutrition,and nutrition pump were significantly different between two groups.Logistic analysis revealed that the activitity time and nutrition pump were independent favourable factors.Besides,patients with intolerance had longer time to exhaust and defecation,and postoperative hospital stay.Conclusion:Insufficient postoperative activity time and nonuse of nutrition pump are risk factors of intolerance of early enteral nutrition,which may slow the recovery of patients.
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<p><b>OBJECTIVE</b>To investigate the predictive value of procalcitonin(PCT) in postoperative intra-abdominal infections (IAI) after definitive operation of intestinal fistulae(IF).</p><p><b>METHODS</b>With the exclusion of emergence operation, preoperative clinical infection, preoperative renal or hepatic dysfunction, and age less than 18 years, a total of 356 consecutive patients who underwent elective digestive tract reconstruction of intestinal fistulae from February 2012 to December 2015 at Intestinal Fistula Center of Jinling Hospital were prospectively enrolled in the study. All the patients were divided into IAI group (26 cases, 21 of anastomosis leakage and 5 of peritoneal abscess) and non-IAI group (330 cases) based on the existence of postoperative IAI. The non-IAI group was then divided into two subgroups of other infection (93 cases) and non-infection(237 cases) according to the presence of other infections. Plasma PCT level, serum CRP concentration and WBC count were assessed preoperatively and on postoperative days (PODs) 1, 3, 5, 7 by immunofluorescence, turbidimetry and automatic blood analyzer, respectively. The predictive value of each marker for IAI was calculated by receiver operating characteristic (ROC) curve.</p><p><b>RESULTS</b>There was no significant difference in general clinical data between IAI and non-IAI group (all P>0.05). The proportions of multi-IF (53.8%, 14/26) and colectomy (61.5%, 16/26) in IAI group were higher than those of non-IAI group [20.0% (66/330), χ=15.847, P=0.000 and 31.2%(103/330), χ=9.961, P=0.002]. Differences of preoperative PCT, CRP and WBC levels among IAI, other infection and non-infection groups were not significant. These three markers all increased obviously and immediately after surgery. PCT and WBC values reached the peak point on POD 1, whereas CRP on POD 3. In IAI group, mean PCT values were (5.4±4.2) μg/L, (2.9±1.9) μg/L and (1.6±1.8) μg/L on POD 1, POD 3 and POD 5, respectively, which were higher than those of other infection group [(4.2±8.7) μg/L, (1.9±3.8) μg/L and (0.6±0.8) μg/L] and non-infection group [(2.7±5.8) μg/L, (1.1±1.7) μg/L and (0.5±0.7) μg/L, all P<0.05]. Mean CRP values in IAI group were 99.4 mg/L and 183.9 mg/L respectively on POD 1 and POD 3,and mean WBC values of IAI group on POD 1, POD 3 and POD 5 were 16.0×10/L, 10.8×10/L and 8.7×10/L, respectively, which were all significantly higher than those in the other 2 groups (all P<0.05). No significant differences were obtained between other infection group and non-infection group in all these three markers (all P>0.05). ROC curve demonstrated that PCT had the biggest area under the curve (AUC) of 0.86 and 0.84 on POD 3 and POD 5, with the cut-off value of 0.98 μg/L and 0.83 μg/L, 92.0% sensitivity and 74.0% specificity, 91.0% sensitivity and 73.0% specificity, respectively. The highest AUC was 0.72 on POD 3 for CRP and 0.71 on POD 3 for WBC, with 80.0% sensitivity and 54.0% specificity, 56.0% sensitivity and 73.0% specificity, respectively.</p><p><b>CONCLUSION</b>The value of procalcitonin above 0.98 μg/L on POD 3 and 0.83 μg/L on POD 5 can predict the occurrence of IAI after definitive operations of intestinal fistulae.</p>
Subject(s)
Female , Humans , Male , Abdominal Abscess , Anastomotic Leak , Area Under Curve , Biomarkers , Blood , Calcitonin , Blood , Colectomy , Elective Surgical Procedures , Intestinal Fistula , General Surgery , Intraabdominal Infections , Postoperative Complications , Epidemiology , Predictive Value of Tests , ROC Curve , Retrospective Studies , Sensitivity and SpecificityABSTRACT
Over the past decades, the evolution of the techniques used in the intensive care has led on one side to better survival rates in ICU patients. On the other side, it has resulted in a growing number of patients who survive an acute event to chronic condition, and who then become dependent on one or more life support treatments. Such patients are called chronic critical illness(CCI) patients. Even these patients can dismiss from intensive care unit (ICU) or transfer to specialized rehabilitation care settings, the mortality of these patients is still very high. Therefore, how to promote the rehabilitation of CCI patients is one of the most important research points of epidemiology, public health and social economics. Exercise training can promote rehabilitation, improve quality of life and independent functional status in these patients, which should be used as one of the standard treatment protocols for CCI patients.
Subject(s)
Humans , Chronic Disease , Critical Care , Critical Illness , Exercise , Exercise Therapy , Intensive Care Units , Quality of LifeABSTRACT
<p><b>OBJECTIVE</b>To investigate the risk factors of surgical site infection (SSI) in definitive surgery of intestinal fistulas.</p><p><b>METHODS</b>Patients with gastrointestinal fistula undergoing definitive operation during November 2011 to November 2013 in Jinling Hospital were prospectively enrolled in the study. Risk factors of SSI were analyzed. Patients' characteristics, surgery-related data and fistula-related data were prospectively collected. Risk factors of SSI were analyzed.</p><p><b>RESULTS</b>A total of 191 cases were enrolled and 51 cases developed SSI. Univariate analysis showed that patients with risk index category (RIC)≥2, length of abdominal incisions>15 cm, and duration of drainage tubes>10 days had significantly higher incidence of SSI (P<0.05). Multivariate Logistics analysis demonstrated that RIC and duration of drainage tube were independent risk factors for SSI (P=0.02, P=0.01, respectively).</p><p><b>CONCLUSIONS</b>RIC≥2 and duration of drainage tubes>10 days are independent risk factors for development of SSI.</p>
Subject(s)
Humans , Incidence , Intestinal Fistula , Multivariate Analysis , Risk Factors , Surgical Wound InfectionABSTRACT
<p><b>BACKGROUND</b>The clinical applications of fibrin glue span over several surgical modalities. The aim of this study was to evaluate the biocompatibility and biodegradation of different formulations of platelet-rich fibrin glue in vivo and examine its effects on the neovascularization of wound sites.</p><p><b>METHODS</b>Human-derived single-unit fibrin glue was prepared. Incisions were made on the backs of rats, and these were coated with homemade glues containing different concentrations of aminomethylbenzoic acid (Groups A-F) or commercial adhesives (Group G). A sham control group was included (Group H). The wounds were examined by histological analysis and immunohistochemistry at several time points.</p><p><b>RESULTS</b>Successful wound closure was achieved in all groups by day 12. Acute inflammation occurred during the first six days, but gradually disappeared. The longest sealant duration was achieved using the lowest concentration of anti-fibrinolytic agent in a 1:10 volume ratio with cryoprecipitate. Expression levels of the platelet endothelial cell adhesion molecule-1 were significantly higher in Groups A and C compared to the control groups (Groups G and H) on day 3 (P < 0.05).</p><p><b>CONCLUSIONS</b>Single-unit platelet-rich fibrin glue has excellent biocompatibility and is associated with the upregulation of neovascularization. The addition of aminomethylbenzoic acid could prevent the degradation of fibrin glue.</p>
Subject(s)
Animals , Female , Humans , Rats , Fibrin Tissue Adhesive , Therapeutic Uses , Immunohistochemistry , Platelet Endothelial Cell Adhesion Molecule-1 , Metabolism , Rats, Sprague-Dawley , Wound HealingABSTRACT
Objective To evaluate the plasma amino acid level alteration and determine amino acid loss in patients with abdominal inflammation and acute renal failure during continuous veno-venous hemofiltration (CVVH). Methods Ten patients with abdominal infection and acute renal failure were admitted to the Nanjing General Hospital of Nanjing Military Command of PLA from September 2008 to September 2009. CVVH was performed with AV600S polysulfone hemofilter for 24 hours. Samples of plasma amino acid were obtained before,at 12 and 24 hours after the beginning of CVVH. High pressure liquid chromatography was used to detect amino acid concentrations in plasma and replacement fluid. All data were analyzed using t test or Wilcoxon rank sum test. Results Of the ten patients, three died of septic shock and three died of multi-organ dysfunction syndrome.The level of plasma amino acids decreased significantly after CVVH, and the levels of histidine, isoleucine, cysteine and glutamine decreased from (22.1 ±10.3), (20.0 ±7.6), (10.3±4.7), (122.3 ±72.2)μmol/L to (5.6 ±3.4), ( 6.4 ± 2.5 ), ( 2.9 ± 2.4 ), (42.5 ± 33.6) μ mol/L. The total plasma amino acid levels significantly reduced by 52% at 12 hours after the beginning of CVVH and by 59% at 24 hours after the beginning of CVVH.The mean amino acid loss was (9631± 1089)mg/d. The mean losses of essential and non-essential amino acids were ( 5072 ± 618 ) mg/d and ( 3747 ± 654 ) mg/d, respectively, with a significant difference ( t = 4. 52,P ＜0.05 ). There was a positive correlation between individual amino acid loss and the plasma concentrations of respective amino acids at 12 hours after the beginning of CVVH ( r = 0. 68, P ＜ 0.05 ). Conclusions Plasma amino acid would be cleared through hemofilter during CVVH in patients with abdominal inflammation and acuterenal failure. As a result, it is necessary to take account of the ultrafiltrate amino acid loss when setting nutritional schedule, especially increasing the non-essential amino acid content of total parenteral nutrition.