[Continuous arteriovenous hemofiltration in the newborn infant]

Area of Science:

• Neonatal Medicine
• Pediatric Nephrology
• Critical Care

Context:

• Acute renal failure (ARF) is a critical condition in newborns.
• Neonates often present with complex etiologies requiring intensive management.
• Limited treatment options exist for neonatal ARF, necessitating innovative approaches.

Purpose:

• To evaluate the efficacy and safety of continuous arterio-venous hemofiltration (CAVH) in treating newborns with ARF.
• To assess the outcomes and complications associated with CAVH in a neonatal population.
• To determine the utility of CAVH as a therapeutic intervention for oligoanuric neonates.

Summary:

• Twelve newborns with ARF of various causes underwent CAVH using Gambro FH 22 or Amicon Minifilter.
• Treatment duration varied (8-120 hours) with a median ultrafiltration of 25 ml/h.
• CAVH was well-tolerated, with complications including hypotension and hypoglycemia; renal function normalized in 6 infants, while 6 died from cardiac malformation or multi-organ failure.

Impact:

• CAVH demonstrates utility in managing neonatal ARF, offering a potential life-saving intervention.
• The study highlights the feasibility of CAVH in a neonatal intensive care setting.
• Findings contribute to the understanding of extracorporeal therapies for pediatric critical illness.