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Published on: February 2, 2021
Continuous renal replacement therapy in critically ill children: single-center experience
Gül Hatice Erkol Tuncer1, Mesiha Ekim1,2, Emel Okulu1,3
1Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey
Insights
Continuous renal replacement therapy (CRRT) is a vital treatment for critically ill children. This study found CRRT improved outcomes, especially in newborns, highlighting its life-saving potential in pediatric intensive care.
Area of Science:
- Pediatric Nephrology
- Critical Care Medicine
- Neonatology
Background:
- Continuous renal replacement therapy (CRRT) offers significant benefits for critically ill children.
- Understanding CRRT's application in pediatric and neonatal intensive care units is crucial for optimizing interventions.
Purpose of the Study:
- To describe CRRT indications, methods, demographics, and outcomes in a pediatric intensive care unit.
- To identify areas for improvement in unit-based CRRT interventions based on patient data.
Main Methods:
- Retrospective evaluation of medical charts for patients receiving CRRT.
- Study period: February 2010 to November 2015 at a single center.
Main Results:
- Fifty patients were included; 28% were newborns. Common indications included acute kidney injury (40%) and fluid overload (30%).
- Continuous venovenous hemodiafiltration (CVVHDF) was the most frequent method (72%). Overall survival was 42%, with significantly higher survival in newborns (P = 0.046).
Conclusions:
- CRRT is a life-saving therapy for critically ill children with acute kidney injury and fluid overload.
- Experienced teams can successfully apply CRRT across all pediatric ages and weights.
Background/Aim:
Continuous renal replacement therapy (CRRT) has significant benefits in the treatment of critically ill children. The objective of this study is to describe the treatment indications, methods, demographics, and outcome of the patients who received CRRT in our pediatric intensive care unit and neonatal care unit, and, according to these results, we also aim to make improvements in our unit-based interventions.
Material And Methods:
In this single-centered study, we retrospectively evaluated medical charts of the patients admitted to our intensive care units and received CRRT between February 2010 and November 2015.
Results:
Fifty of 60 patients were included in this study. Newborns made up 28% (n = 14) of the patients. The mean body weight was 18.4 kg (2.3-98 kg). CRRT indications were fluid overload (30%), acute kidney injury (40%), metabolic disease (24%), electrolyte impairment (4%), and drug intoxication (2%). The most common method of CRRT was continuous venovenous hemodiafiltration (CVVHDF) (72%). The mean duration of CRRT was 135 hours (1-864) and totally 143 filters, polyarylethersulfon (n = 23.46%) and polyacrylonitrile (n = 27.54%) were used. Overall survival was 42%. The survival rate of newborns was significantly higher (P = 0.046).
Conclusion:
CRRT is a lifesaving method that can be applied to critically ill children with acute kidney injury and fluid overload at any age and weight by experienced teams.
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