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Early experience with continuous arteriovenous hemofiltration in critically ill pediatric patients.
Leone MR, Jenkins RD, Golper TA, Alexander SR
(1986) Crit Care Med 14: 1058-63
MeSH Terms: Acute Kidney Injury, Anuria, Blood, Child, Preschool, Critical Care, Equipment Design, Female, Humans, Infant, Infant, Newborn, Male, Peritoneal Dialysis, Renal Dialysis, Ultrafiltration
Show Abstract · Added August 10, 2015
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.
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14 MeSH Terms
Continuous arteriovenous hemofiltration in the critically ill patient.
Warnholtz A, Slater AD, Golper TA
(1991) J Ky Med Assoc 89: 111-4
MeSH Terms: Adult, Bacterial Infections, Coronary Artery Bypass, Critical Care, Hemofiltration, Humans, Male, Middle Aged, Pulmonary Edema, Thromboembolism
Show Abstract · Added August 7, 2015
Continuous arteriovenous hemofiltration (CAVH) is a simple extracorporeal treatment for fluid overload, electrolyte imbalances, and removal of uremic toxins. The CAVH technique can be initiated rapidly and allows effective fluid removal without compromising cardiovascular status. This article describes two illustrative cases where CAVH was used to treat fluid overload accompanying in one case cardiogenic shock and in the other case septic shock. CAVH may have contributed to the removal of sepsis-related vasodilators as well as excess fluid. This therapy is an attractive alternative to hemodialysis in the critical care setting and may be the treatment of choice in hemodynamically unstable patients.
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10 MeSH Terms