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Related Experiment Videos

Continuous renal replacement therapy in critically ill patients

G Zobel1, S Rödl, B Urlesberger

  • 1Department of Pediatrics, University of Graz, Austria. gerfried.zobel@kfunigraz.ac.at

Kidney International. Supplement
|May 9, 1998
PubMed
Summary

Continuous renal replacement therapy (CRRT) effectively supports critically ill neonates with kidney failure, improving fluid balance and metabolic issues. This study highlights CRRT

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Area of Science:

  • Pediatric Nephrology
  • Neonatal Intensive Care
  • Critical Care Medicine

Background:

  • Critically ill neonates often experience acute kidney injury (AKI) and fluid overload.
  • Traditional therapies may be insufficient for managing complex fluid and metabolic derangements in this population.

Purpose of the Study:

  • To evaluate the efficacy and safety of continuous renal replacement therapy (CRRT) in critically ill neonates.
  • To assess CRRT's impact on fluid balance, metabolic control, and survival rates.

Main Methods:

  • Retrospective analysis of 36 critically ill neonates undergoing continuous arterio-venous (AV) or veno-venous (VV) renal support.
  • Four neonates received continuous ultrafiltration (CUF) during extracorporeal membrane oxygenation (ECMO) for hypervolemia.

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  • Utilized small-volume hemofilters and microprocessor-controlled units for precise fluid management.

    • Main Results:

    • CRRT, in both AV and VV modes, demonstrated effective fluid balance control and metabolic correction.
    • Mean duration of renal support was 97 hours, with significant improvements in blood flow and ultrafiltration rates.
    • Overall survival rate was 66%, with CRRT-related complications including bleeding and thrombosis.

    Conclusions:

    • Continuous renal replacement therapy is a highly effective renal support method for critically ill neonates.
    • CRRT successfully manages fluid overload and metabolic disturbances, contributing to improved outcomes.
    • Optimizing CRRT parameters, such as adding dialysate, can further enhance urea clearance.