Back
For best output, select "Paper Size" as "A4" and "Margin" as "0" or "None".
To save or print to PDF, please select Print Destination > Save as PDF, enable Background Graphics under "More Settings", then click "Save".
During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Hyperammonemia syndrome (HS) is a rare but often fatal condition that occurs in immunosuppressed individuals, affecting approximately 4% of lung transplant recipients. It is characterized by progressively rising serum ammonia levels that overwhelms the liver’s clearance capacity. Ammonia readily crosses the blood-brain barrier and, together with glutamate, is converted to glutamine within astrocytes. Glutamine acts as an active osmolyte, and as ammonia levels quickly rise, the body’s ability to maintain intracellular osmolality becomes overwhelmed. This imbalance leads to astrocyte swelling, cerebral edema and ultimately death. Acute hyperammonemia requires rapid management through extracorporeal ammonia removal. Continuous renal replacement therapy (CRRT) serves as a critical intervention for rapidly and effectively reducing ammonia levels. We present a case of refractory hyperammonemia syndrome requiring multiple renal replacement therapy intervention, eventually double CRRT to normalize the hyperammonemia.
Case report
Hyperammonemia syndrome secondary to disseminated Ureaplasma infection is often refractory to treatment. Ureaplasma hydrolyzes urea to ammonia and carbon dioxide. Overwhelming the liver’s capacity to clear ammonia, neurological sequelae can be detrimental with life threatening cerebral edema. Along with antimicrobial treatment, extracorporeal clearance ammonia remains cornerstone in time sensitive management of those patients. Generally CRRT or intermittent hemodialysis are able to correct the hyperammonemia. While, intermittent hemodialysis is efficient in clearance of hyperammonemia, there is rebound phenomenon, so CRRT is generally preferred, especially in unstable patients. The usual recommended dose to start is between 50 ml/kg/hr and if needed can go upto 80 ml/kg/hr. In this case however, we had to continue to increase the support to the point of requiring two CVVHD machines in parallel to correct the hyperammonemia.
