Continuous arteriovenous haemofiltration in critically ill children

Area of Science:

• Pediatric Nephrology
• Intensive Care Medicine
• Renal Replacement Therapy

Background:

• Acute renal failure (ARF) is a critical condition in children, often associated with complex medical scenarios like post-cardiac surgery or liver failure.
• Managing fluid balance and uremic toxins is crucial for critically ill pediatric patients with ARF.

Purpose of the Study:

• To evaluate the efficacy and outcomes of continuous arteriovenous haemofiltration (CAVH) in pediatric patients with acute renal failure.
• To assess the role of CAVH in fluid management and uremia control in critically ill children.

Main Methods:

• Retrospective analysis of 24 pediatric patients treated with CAVH between 1987 and 1991 for ARF.
• Utilized femoral vessels for vascular access and various hemofilters based on patient size.
• Monitored ultrafiltration rates and fluid clearance to manage fluid overload and uremia.

Main Results:

• CAVH was indicated for oliguria or fluid overload in all patients.
• Adequate control of uremia was achieved in 18 out of 24 patients.
• Nine children survived with renal function recovery; 15 (62.5%) died from multiorgan failure.

Conclusions:

• Continuous arteriovenous haemofiltration (CAVH) is an effective supportive therapy for critically ill children experiencing acute renal failure.
• While CAVH aids in managing fluid and uremic complications, overall survival is significantly impacted by the severity of underlying multiorgan failure.