Early experience with continuous arteriovenous hemofiltration in critically ill pediatric patients.

Abstract:

:The applicability of continuous arteriovenous hemofiltration (CAVH) for renal replacement therapy was evaluated in three infants and two young children with catastrophic medical and surgical illnesses. In the first four patients, CAVH was used in conjunction with either peritoneal or hemodialysis. In the fifth patient, CAVH was the sole renal replacement therapy employed; in this critically ill anuric infant, we were best able to evaluate the ability of CAVH to continuously control fluid, electrolyte, and acid-base balance, and allow the administration of adequate parenteral nutrition. The difficulties encountered were related to anticoagulation, establishment of adequate vascular access, and selection of an appropriate hemofilter for the performance of the technique. Despite the application of suction-assistance, we were unable to effectively employ a prototype pediatric hemofilter to attain a level of plasma ultrafiltration consistent with the objectives of therapy. However, we were able to effectively and safely employ an adult hemofilter for these purposes; modifications were made in the adult hemofilter system before its application in the smallest pediatric patients. Our experience suggests that, even in critically ill infants, CAVH can be successfully applied as an effective renal replacement therapy. However, further experience is required before its potential impact on patient survival can be assessed.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Leone MR,Jenkins RD,Golper TA,Alexander SR

doi

10.1097/00003246-198612000-00014

subject

Has Abstract

pub_date

1986-12-01 00:00:00

pages

1058-63

issue

12

eissn

0090-3493

issn

1530-0293

journal_volume

14

pub_type

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