Continuous arterial-venous diahemofiltration and continuous veno-venous diahemofiltration in infants and children

Area of Science:

• Pediatric Nephrology
• Critical Care Medicine
• Renal Replacement Therapy

Background:

• Continuous blood purification techniques, including continuous arterial-venous diahemofiltration (CAVH(D)) and continuous veno-venous diahemofiltration (CVVH(D)), are increasingly used in pediatric patients requiring renal replacement therapy (RRT).
• The application of these advanced RRT methods in infants and children presents unique challenges, particularly concerning the availability and suitability of specialized equipment.

Purpose of the Study:

• To address the availability of techniques and equipment for CAVH(D)/CVVH(D) in the unique infant and pediatric population.
• To discuss the use of CAVH(D)/CVVH(D) in comparison to other RRT modalities like hemodialysis and peritoneal dialysis for pediatric patients.

Main Methods:

• Review of current literature and clinical practices regarding continuous blood purification in pediatric RRT.
• Discussion of challenges and solutions related to pediatric-specific equipment and techniques for CAVH(D)/CVVH(D).

Main Results:

• While CAVH(D)/CVVH(D) offers a viable RRT option for pediatric patients, significant limitations exist due to the lack of readily available, infant- and pediatric-specific equipment.
• The decision to utilize CAVH(D) or CVVH(D) over other RRT methods is individualized, considering patient-specific factors and resource availability.

Conclusions:

• Continuous blood purification is an evolving RRT option for critically ill children, but equipment challenges must be overcome.
• Careful consideration of available resources and patient needs is crucial when selecting the optimal RRT modality for infants and children.