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Related Experiment Videos

Continuous arteriovenous renal replacement systems for critically ill children.

G Zobel1, E Ring, V Zobel

  • 1Department of Paediatrics, University of Graz, Austria.

Pediatric Nephrology (Berlin, Germany)
|April 1, 1989
PubMed
Summary

Continuous renal replacement therapy (CRRT) effectively managed fluid overload and azotemia in critically ill children. While generally safe, complications like femoral artery thrombosis occurred, with an overall mortality of 35%.

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Area of Science:

  • Pediatric Nephrology
  • Critical Care Medicine
  • Renal Replacement Therapy

Background:

  • Critically ill pediatric patients often experience oliguria or anuria.
  • Fluid overload and azotemia are significant complications in these patients.
  • Arteriovenous renal replacement systems offer a potential solution for managing these conditions.

Purpose of the Study:

  • To evaluate the efficacy and safety of five different arteriovenous renal replacement systems in critically ill oliguric or anuric children.
  • To assess fluid control, urea clearance, and ultrafiltration rates.
  • To identify complications associated with these therapies.

Main Methods:

  • Utilized five distinct arteriovenous renal replacement systems: SCU, CAVH, suction-supported CAVH, AVHDF, and CAVHD.

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  • Treated 23 critically ill children over varying patient days for each modality.
  • Monitored fluid overload, urea clearances, and ultrafiltration rates.

    • Main Results:

    • Slow continuous ultrafiltration (SCU) provided excellent fluid overload control within 47 ± 17 hours.
    • Urea clearances varied from 5.6 ± 2.1 ml/min/m² (CAVH) to 15.3 ± 3.7 ml/min/m² (CAVHD).
    • Ultrafiltration rates ranged from 1.6 ± 0.3 to 11.5 ± 2.4 ml/min/m²; femoral artery thrombosis was the main complication.

    Conclusions:

    • Arteriovenous renal replacement therapies are effective in managing fluid overload and azotemia in critically ill children.
    • Different systems offer varying degrees of efficacy in clearance and ultrafiltration.
    • While generally safe, potential complications necessitate careful monitoring and patient selection.