Early experience with continuous arteriovenous hemofiltration in critically ill pediatric patients

M. R. Leone, Randall Jenkins, T. A. Golper, S. R. Alexander

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

The applicability of continuous arteriovenous hemofiltration (CAVH) for renal replacement therapy was evaluated in three infants and two young children with catastrophic medical and surgical illnesses. In the first four patients, CAVH was used in conjunction with either peritoneal or hemodialysis. In the fifth patient, CAVH was the sole renal replacement therapy employed; in this critically ill anuric infant, we were best able to evaluate the ability of CAVH to continuously control fluid, electrolyte, and acid-base balance, and allow the administration of adequate parenteral nutrition. The difficulties encountered were related to anticoagulation, establishment of adequate vascular access, and selection of an appropriate hemofilter for the performance of the technique. Despite the application of suction-assistance, we were unable to effectively employ a prototype pediatric hemofilter to attain a level of plasma ultrafiltration consistent with the objectives of therapy. However, we were able to effectively and safely employ an adult hemofilter for these purposes; modifications were made in the adult hemofilter system before its application in the smallest pediatric patients. Our experience suggests that, even in critically ill infants, CAVH can be successfully applied as an effective renal replacement therapy. However, further experience is required before its potential impact on patient survival can be assessed.

Original languageEnglish (US)
Pages (from-to)1058-1063
Number of pages6
JournalCritical Care Medicine
Volume14
Issue number12
StatePublished - 1986

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Hemofiltration
Critical Illness
Renal Replacement Therapy
Pediatrics
Acid-Base Equilibrium
Parenteral Nutrition
Ultrafiltration
Suction
Electrolytes
Blood Vessels
Renal Dialysis
Survival

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Early experience with continuous arteriovenous hemofiltration in critically ill pediatric patients. / Leone, M. R.; Jenkins, Randall; Golper, T. A.; Alexander, S. R.

In: Critical Care Medicine, Vol. 14, No. 12, 1986, p. 1058-1063.

Research output: Contribution to journalArticle

Leone, M. R. ; Jenkins, Randall ; Golper, T. A. ; Alexander, S. R. / Early experience with continuous arteriovenous hemofiltration in critically ill pediatric patients. In: Critical Care Medicine. 1986 ; Vol. 14, No. 12. pp. 1058-1063.
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