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[Continuous arteriovenous hemofiltration in the newborn].

H Hilt1, J Goecke, H J Gramm

  • 1Klinik für Anaesthesiologie und operative Intensivmedizin, Klinikum Steglitz der Freien Universität Berlin.

Der Anaesthesist
|September 1, 1988
PubMed
Summary

Continuous arteriovenous hemofiltration (CAVH) shows feasibility in newborns with septic acute renal failure (ARF). While not a dialysis substitute, CAVH aided weight loss and improved pulmonary function in an infant case.

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Area of Science:

  • Pediatric Nephrology
  • Critical Care Medicine

Background:

  • Acute renal failure (ARF) is a severe postoperative complication in newborns and infants.
  • Peritoneal dialysis is often not feasible postoperatively, creating a need for alternative treatments.
  • Continuous arteriovenous hemofiltration (CAVH) is established in adults and older children.

Observation:

  • A case report of an 8-week-old infant with postoperative septic ARF is presented.
  • The infant underwent CAVH using a Minifilter and Shaldon catheters.
  • Intermittent hemodialysis without ultrafiltration was also performed.

Findings:

  • Ultrafiltration rates of 2-24 ml/h (mean 12.8 ml/h) led to significant weight loss.
  • Pulmonary function improved during CAVH treatment.

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  • The infant ultimately died of septic multiorgan failure on day 5 of treatment.

    • Implications:

    • CAVH demonstrated feasibility in a newborn with septic ARF.
    • CAVH is recommended for overhydrated infants with oligoanuric ARF.
    • CAVH is not a sufficient substitute for dialysis in this population.