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

Leone MR, Jenkins RD, Golper TA, Alexander SR
Crit Care Med. 1986 14 (12): 1058-63

PMID: 3780250 · DOI:10.1097/00003246-198612000-00014

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.

MeSH Terms (14)

Acute Kidney Injury Anuria Blood Child, Preschool Critical Care Equipment Design Female Humans Infant Infant, Newborn Male Peritoneal Dialysis Renal Dialysis Ultrafiltration

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