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Published on: July 19, 2011
Pump-assisted hemofiltration in infants with acute renal failure
E N Ellis1, D Pearson, L Robinson
1Division of Pediatric Nephrology, Arkansas Children's Hospital, Little Rock 72202.
Pediatric Nephrology (Berlin, Germany)
|August 1, 1993
Summary
Pump-assisted hemofiltration (PAHF) offers a viable treatment for acute renal failure in infants when arterial access is challenging. This method, utilizing a volumetric infusion pump, demonstrated safety and efficacy in a small cohort of critically ill infants.
Area of Science:
- Pediatric Nephrology
- Critical Care Medicine
- Renal Replacement Therapy
Background:
- Acute renal failure (ARF) in critically ill infants presents management challenges, particularly regarding vascular access for hemofiltration.
- Traditional hemofiltration often requires arterial access, which is difficult to obtain and maintain in infants.
Purpose of the Study:
- To describe the technique and evaluate the experience of using pump-assisted hemofiltration (PAHF) in infants with ARF.
- To assess the feasibility and safety of PAHF in a pediatric population.
Main Methods:
- Ten infants with ARF underwent PAHF using double-lumen venous catheters or dual venous catheters for access.
- Standard hemofilters and intravenous tubing were connected to a volumetric infusion pump for blood flow regulation.
- Infants ranged from 5-575 days old and weighed 2.8-11.4 kg, with diagnoses including congenital heart disease, sepsis, and renal dysplasia.
Main Results:
- PAHF was successfully implemented in all ten infants, with an average treatment duration of 158 hours.
- Complications were minimal, including localized bleeding in two patients and asymptomatic hyponatremia in five.
- The technique proved adaptable to various venous access strategies.
Conclusions:
- Pump-assisted hemofiltration, regulated by a volumetric infusion pump, is an acceptable and feasible therapy for acute renal failure in infants.
- Adequate nurse training is crucial for the safe and effective application of PAHF in this vulnerable population.
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