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Lessons Learned from a Small Pediatric Continuous Renal Replacement Therapy Program

Tanya Holt1, Olivia Griffin2, Amelie Cyr2

  • 1Jim Pattison Children's Hospital, Pediatric Intensive Care, 103 Hospital Drive, S7N 0W8, Saskatoon, Saskatchewan, Canada.

Critical Care Research and Practice
|November 29, 2021
PubMed

Insights

Small pediatric intensive care units can successfully implement continuous renal replacement therapy (CRRT). This study shows a small-volume CRRT program achieved good outcomes and quality indicators, demonstrating feasibility for other centers.

Area of Science:

  • Pediatric Nephrology
  • Critical Care Medicine
  • Renal Replacement Therapy

Background:

  • Continuous renal replacement therapy (CRRT) is crucial in pediatric intensive care units (PICUs).
  • Quality indicators (QIs) assess CRRT safety and effectiveness.
  • Limited data exists on outcomes and QIs for smaller CRRT programs.

Purpose of the Study:

  • To evaluate the efficiency, effectiveness, and outcomes of a small-volume CRRT program.
  • To assess the feasibility of implementing CRRT in resource-limited settings.

Main Methods:

  • Retrospective study of 82 patients receiving CRRT over 13 years.
  • Analysis of patient survival, mortality predictors, and CRRT quality indicators.

Main Results:

  • Overall survival to discharge was 79%.
  • Independent predictors of mortality included sepsis/nonseptic shock and delayed CRRT initiation.
  • The program met positive outcomes for CRRT efficiency, timely initiation, dosing, and adverse event rates.

Conclusions:

  • Small-volume CRRT programs can provide safe and effective care.
  • This study highlights the opportunity for smaller centers to establish CRRT services.
  • Positive outcomes and QIs demonstrate the viability of CRRT in diverse settings.

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