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Continuous renal replacement therapy for non-renal indications: experience in children
Alik Kornecki1, Riva Tauman, Ronit Lubetzky
1Pediatric Intensive Care Unit, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. alikk@netvision.net.il
Background:
The role of continuous renal replacement therapy in patients with acute renal failure is well recognized. CRRT has also become an important modality of treatment in various acute situations without renal failure.
Objectives:
To describe our experience with CRRT in acutely ill infants and children without renal failure.
Methods:
We analyzed all infants and children who underwent CRRT during the years 1998-2000 in the pediatric intensive care unit and we focus our report on those who were treated for non-renal indications.
Results:
Fourteen children underwent 16 sessions of CRRT. The indications for CRRT were non-renal in 7 patients (age range 8 days to 16 years, median = 6.5). Three children were comatose from maple syrup urine disease, three were in intractable circulatory failure secondary to septic shock or systemic inflammatory response, and one had sepsis with persistent lactic acidosis and hypernatremia. Three children underwent continuous hemodiafiltration and four had continuous hemofiltration. The mean length of the procedure was 35 +/- 24 hours. All patients responded to treatment within a short period (2-4 hours). No significant complications were observed. Two patients experienced mild hypothermia (34 degrees C), one had transient hypotension and one had an occlusion of the cannula requiring replacement.
Conclusion:
Our findings suggest that CRRT is a safe and simple procedure with a potential major therapeutic value for treating acute non-renal diseases in the intensive care setting.