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Related Experiment Videos

Plasma exchange using a continuous venovenous hemofiltration machine in children.

Ewa Ciechanska1, Lauren Segal, Hubert Wong

  • 1Department of Pediatrics, Division of Nephrology, Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada.

Blood Purification
|September 13, 2005
PubMed
Summary

Continuous venovenous hemofiltration machines offer a safe method for pediatric plasma exchange therapy. This approach effectively manages anticoagulation and calcium levels, proving beneficial for children requiring plasma exchange.

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Area of Science:

  • Pediatric Nephrology
  • Critical Care Medicine
  • Extracorporeal Therapies

Background:

  • Growing interest in utilizing continuous venovenous hemofiltration (CVVH) machines for plasma exchange (PE) in pediatric patients.
  • Plasma exchange is a crucial therapy for various pediatric conditions.
  • Establishing safe and effective CVVH-based PE protocols for children is essential.

Purpose of the Study:

  • To evaluate the safety and efficacy of using continuous venovenous hemofiltration machines for plasma exchange in a pediatric population.
  • To determine optimal anticoagulation and fluid management strategies for pediatric CVVH-PE.
  • To assess the feasibility of implementing this technique in pediatric intensive care settings.

Main Methods:

  • Retrospective analysis of 7 pediatric patients undergoing 61 plasma exchange treatments.

Related Experiment Videos

  • Utilized the Baxter/Edwards Lifesciences BM25 machine with standard plasma filters (Asahi Plasmaflo).
  • Monitored anticoagulation with activated clotting times and adjusted heparin infusion rates; calcium infusion managed potential hypocalcemia.

    • Main Results:

    • Achieved an average total exchange volume of 1.5 times plasma volume.
    • Effective anticoagulation was maintained with heparin infusion rates of 35 units/kg/h, while initial heparin boluses were often subtherapeutic.
    • Calcium infusion at 0.11 +/- 0.05 mmol/kg/h successfully prevented hypocalcemia; one patient experienced a membrane reaction.

    Conclusions:

    • The described setup using CVVH machines for plasma exchange is a safe approach for pediatric patients.
    • This method demonstrates effective anticoagulation and mineral balance management.
    • The protocol is potentially adaptable for implementation in other pediatric critical care centers.