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Continuous Renal Replacement Therapy (CRRT) in Children and the Specialized CRRT Team: A 14-Year Single-Center Study

Keum Hwa Lee1,2,3, In Suk Sol4,5, Jung Tak Park3,6

  • 1Department of Pediatrics, Yonsei University College of Medicine, Yonsei-ro 50, Seodaemun-gu, C.P.O. Box 8044, Seoul 03722, Korea.

Journal of Clinical Medicine
|January 8, 2020
PubMed

Insights

A specialized pediatric continuous renal replacement therapy (CRRT) team significantly increased CRRT utilization in critically ill children. This dedicated team improved treatment accessibility and application in pediatric intensive care units.

Area of Science:

  • Pediatric Nephrology
  • Critical Care Medicine
  • Renal Replacement Therapy

Background:

  • Continuous renal replacement therapy (CRRT) is vital for critically ill children.
  • Korea's only specialized pediatric CRRT team (SCT) operates at Severance Hospital.
  • The SCT comprises pediatric intensivists, a pediatric nephrologist, and specialized nurses.

Purpose of the Study:

  • To evaluate the impact of establishing a specialized pediatric CRRT team (SCT) on CRRT utilization.
  • To compare CRRT practices and patient characteristics before and after the SCT's implementation.

Main Methods:

  • Retrospective single-center analysis of pediatric patients receiving CRRT from 2003 to 2016.
  • Patients were divided into two groups: before SCT (Group A) and after SCT (Group B).
  • Data collected included demographics, diagnoses, CRRT parameters, and intensive care unit (ICU) duration.

Main Results:

  • The study included 263 pediatric patients (Group A: 51, Group B: 212).
  • Group B patients were significantly younger and received CRRT at a lower blood flow rate.
  • Increased use of vasopressors, continuous veno-venous hemodiafiltration (CVVHDF), nafamostat mesilate, and ECMO-CRRT was observed in Group B.

Conclusions:

  • The establishment and operation of the specialized pediatric CRRT team (SCT) were associated with increased CRRT utilization.
  • The SCT model may enhance the application of CRRT in pediatric critical care.
  • This 14-year experience highlights the importance of specialized teams in pediatric intensive care.

Keywords:
continuous renal replacement therapy (CRRT)retrospective studyspecialized CRRT team (SCT)

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