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Use of the Aquadex™ system for ultrafiltration therapy in a hemodynamically unstable pediatric patient

Meghan K Farrell1, Puneet Bhatla2, Catherine Bull1

  • 1Department of Cardiothoracic Surgery, Division of Pediatric and Adult Congenital Cardiac Surgery, Langone Medical Center, New York, NY, USA.

Journal of Pediatric Intensive Care
|June 20, 2019
PubMed

Insights

Ultrafiltration therapy using the Aquadex™ system safely managed fluid overload and acute kidney injury in a pediatric cardiac patient. This intervention facilitated weaning from ventilatory and inotropic support post-surgery.

Area of Science:

  • Pediatric Cardiology
  • Critical Care Medicine
  • Nephrology

Background:

  • Congenital heart surgery can lead to fluid overload and acute kidney injury (AKI).
  • Hemodynamic instability and multiple organ dysfunction syndrome (MODS) are significant post-operative concerns.

Observation:

  • An 11-year-old male with complex single ventricle anatomy developed AKI and fluid overload post-repair.
  • The patient presented with hemodynamic instability and required ventilatory and inotropic support.

Findings:

  • Ultrafiltration therapy with the Aquadex™ system was initiated for fluid management in the setting of AKI.
  • The Aquadex™ system safely achieved a negative fluid balance.
  • Successful fluid removal allowed for weaning of ventilatory and inotropic support.

Implications:

  • Ultrafiltration therapy is a feasible treatment option for hemodynamically unstable pediatric cardiac patients with fluid overload and AKI.
  • This case highlights the potential benefits of Aquadex™ in improving outcomes after complex congenital heart surgery.
  • Further research may explore the broader application of ultrafiltration in pediatric critical care settings.

Keywords:
Ultrafiltrationacute kidney injurycardiac surgerycardiopulmonary bypasscongenital heart defectsheart failure

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