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continuous renal replacement therapy children

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https://www.readbyqxmd.com/read/28361230/acute-kidney-injury-and-fluid-overload-in-infants-and-children-after-cardiac-surgery
#1
David M Kwiatkowski, Catherine D Krawczeski
Acute kidney injury is a common and serious complication after congenital heart surgery, particularly among infants. This comorbidity has been independently associated with adverse outcomes including an increase in mortality. Postoperative acute kidney injury has a complex pathophysiology with many risk factors, and therefore no single medication or therapy has been demonstrated to be effective for treatment or prevention. However, it has been established that the associated fluid overload is one of the major determinants of morbidity, particularly in infants after cardiac surgery...
March 30, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28337077/antithrombin-iii-doses-rounded-to-available-vial-sizes-in-critically-ill-pediatric-patients
#2
Winifred M Stockton, Eimeira Padilla-Tolentino, Carolyn E Ragsdale
OBJECTIVES: Children have decreased levels of antithrombin III (AT III) compared to adults. These levels may be further decreased during acute illness. Administration of exogenous AT III can increase anticoagulant efficacy. The objective of this study was to evaluate AT III doses rounded to available vial sizes compared to partial vial doses in critically ill pediatric patients, including patients receiving extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT)...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28247082/membrane-pressures-predict-clotting-of-pediatric-continuous-renal-replacement-therapy-circuits
#3
Aadil Kakajiwala, Thomas Jemielita, John Z Hughes, Kimberly Windt, Michelle Denburg, Stuart L Goldstein, Benjamin Laskin
BACKGROUND: Clotting of continuous renal replacement therapy (CRRT) circuits leads to inadequate clearance, decreased ultrafiltration, and increased resource use. We identified factors associated with premature clotting of circuits during CRRT in children. METHODS: In a retrospective cohort of 26 children (median age 11.8 years) receiving 79 CRRT circuits (51 heparin, 22 citrate, 6 using no anticoagulation), we captured hourly pressure, flow, and fluid removal rates along with all activated clotting time (ACT) and circuit ionized calcium measurements...
March 1, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28202121/-oliguria-and-acute-renal-dysfunction-in-a-six-month-old-infant
#4
Ya-Jie Cui, Chun-Lan Song, Yi-Bing Cheng
The infant (a girl aged 6 months) was admitted to the hospital because of oliguria and acute renal dysfunction. The laboratory examination results showed serious metabolic acidosis and increased blood urea nitrogen and serum creatinine levels. The patient continued to be anuric after 10 days of treatment with continuous renal replacement therapy (CRRT). she died a day later. The family history showed that the patient's sister died of acute renal failure 6 months after birth. The genomic sequencing results showed AGXT mutation in the patient and confirmed the diagnosis of primary hyperoxaluria type 1 (PH1)...
February 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28157807/factors-associated-with-mortality-in-continuous-renal-replacement-therapy-for-pediatric-patients-with-acute-kidney-injury
#5
Seung Jun Choi, Eun-Ju Ha, Won Kyoung Jhang, Seong Jong Park
OBJECTIVES: To analyze the epidemiology of pediatric acute kidney injury requiring continuous renal replacement therapy and identify prognostic factors affecting mortality rates. DESIGN: Retrospective analysis. SETTING: PICU of a tertiary medical center. PATIENTS: One hundred-twenty three children diagnosed with acute kidney injury requiring continuous renal replacement therapy. INTERVENTIONS: None...
February 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28118627/prostacyclin-as-an-anticoagulant-for-continuous-renal-replacement-therapy-in-children
#6
Akash Deep, Mohammad Zoha, Pompa Dutta Kukreja
Effective delivery of continuous renal replacement therapy (CRRT) depends on the longevity of the filter and circuit used in the CRRT machine. Safe and effective anticoagulation is crucial for maintaining the patency of these circuits. In children, heparin and citrate are the commonly used anticoagulants but they are limited by serious side effects and thus calls for meticulous monitoring. In conditions where neither of these can be used, prostacyclin can be an effective alternative. Prostacyclin is a platelet inhibitor that can be safely used as an efficient anticoagulant in CRRT...
2017: Blood Purification
https://www.readbyqxmd.com/read/28070667/erratum-to-regional-citrate-anticoagulation-for-continuous-renal-replacement-therapy-in-children
#7
Mayerly Prada Rico, Jaime Fernández Sarmiento, Ana María Rojas Velasquez, Luz Stella González Chaparro, Ricardo Gastelbondo Amaya, Hernando Mulett Hoyos, Daniel Tibaduiza, Ana Maria Quintero Gómez
No abstract text is available yet for this article.
January 9, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27977538/continuous-venovenous-hemofiltration-in-children-less-than-or-equal-to-10-kg-a-single-center-experience
#8
Sirée Kaempfen, Pompa Dutta-Kukreja, Quen Mok
OBJECTIVES: The aim of this study was to review the data from patients with a body weight less than or equal to 10 kg who required continuous venovenous hemofiltration, to assess the feasibility and problems associated with continuous venovenous hemofiltration in this population and compare the results with the current literature. DESIGN: Retrospective study design. SETTING: PICU in a single tertiary pediatric referral center. PATIENTS: Children less than or equal to 10 kg who received continuous venovenous hemofiltration between January 2008 and July 2014 were included in the study...
February 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27951558/evolution-of-technology-for-continuous-renal-replacement-therapy-forty-years-of-improvements
#9
Claudio Ronco
Continuous arteriovenous hemofiltration (CAVH) was proposed in 1977 as an alternative treatment for acute renal failure in patients in whom peritoneal dialysis or hemodialysis was clinically or technically precluded. In the mid-1980s, this technique was extended to infants and children. CAVH presented important advantages in the areas of hemodynamic stability, control of circulating volume, and nutritional support. However, there were serious shortcomings such as the need for arterial cannulation and limited solute clearance...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/27941742/experience-of-percutaneous-versus-surgically-placed-catheter-for-continuous-ambulatory-peritoneal-dialysis-in-children-with-chronic-kidney-disease-stage-v
#10
S Afroz, T Ferdaus, S A Khondokar, M H Khan, M Hanif
The lifespan and outcome of end stage renal disease (ESRD) children have dramatically improved since the development of continuous ambulatory peritoneal dialysis (CAPD), it offers several advantages over hemodialysis. Percutaneous placement of CAPD catheters in children is minimally invasive, reliable, safe and cost-effective method. Percutaneous method of CAPD catheter insertion can be used in children to avoid the complications of general anesthesia and surgery. This study was done to evaluate the efficacy of CAPD in children, to find out the complication profile of CAPD & to compare the advantages of surgical versus percutaneously placed CAPD catheters in children...
October 2016: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/27896442/regional-citrate-anticoagulation-for-continuous-renal-replacement-therapy-in-children
#11
Mayerly Prada Rico, Jaime Fernández Sarmiento, Ana María Rojas Velasquez, Luz Stella González Chaparro, Ricardo Gastelbondo Amaya, Hernando Mulett Hoyos, Daniel Tibaduiza, Ana Maria Quintero Gómez
BACKGROUND: Anticoagulation of the continuous renal replacement therapy (CRRT) circuit is an important technical aspect of this medical procedure. Most studies evaluating the efficacy and safety of citrate use have been carried out in adults, and little evidence is available for the pediatric patient population. The aim of this study was to compare regional citrate anticoagulation versus systemic heparin anticoagulation in terms of the lifetime of hemofilters in a pediatric population receiving CRRT at a pediatric center in Bogota, Colombia...
November 28, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27786420/outcomes-of-continuous-renal-replacement-therapy-with-regional-citrate-anticoagulation-in-small-children-after-cardiac-surgery-experience-and-protocol-from-a-single-center
#12
Anna Musielak, Alfred Warzywoda, Michał Wojtalik, Bartłomiej Kociński, Paweł Kroll, Danuta Ostalska-Nowicka, Jacek Zachwieja
Patients after a cardiac surgery in cardiopulmonary bypass often present an acute kidney failure. Continuous renal replacement therapy (CRRT) is often required. The aim of this study was to present effectiveness and safety of CRRT with regional citrate anticoagulation (RCA-CRRT) in small children after cardiac surgery. A retrospective analysis was conducted on 15 patients after cardiac surgery and who had RCA-CRRT performed in 2014. The established protocol was followed. Mean time on the RCA-CRRT was 192 h 40 min with the circuit mean lifetime of 43 h 33 min...
December 2016: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/27738262/underweight-status-is-an-independent-predictor-of-in-hospital-mortality-in-pediatric-patients-on-extracorporeal-membrane-oxygenation
#13
Pilar Anton-Martin, Michael Papacostas, Elisabeth Lee, Paul A Nakonezny, Michael L Green
BACKGROUND: Malnutrition is associated with an increased risk of mortality in patients admitted to the intensive care unit. Children requiring extracorporeal membrane oxygenation (ECMO) support represent an extremely ill subset of this population. There is a lack of data on the impact of nutrition state on survival in this cohort. We examined the association between being underweight and in-hospital mortality among children supported with ECMO. MATERIALS AND METHODS: This article reports on an observational retrospective cohort study performed among neonatal and pediatric patients supported with ECMO in a tertiary children's hospital from May 1996 through June 2013...
October 13, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27585904/clinical-pharmacology-studies-in-critically-ill-children
#14
REVIEW
Nilay Thakkar, Sara Salerno, Christoph P Hornik, Daniel Gonzalez
Developmental and physiological changes in children contribute to variation in drug disposition with age. Additionally, critically ill children suffer from various life-threatening conditions that can lead to pathophysiological alterations that further affect pharmacokinetics (PK). Some factors that can alter PK in this patient population include variability in tissue distribution caused by protein binding changes and fluid shifts, altered drug elimination due to organ dysfunction, and use of medical interventions that can affect drug disposition (e...
January 2017: Pharmaceutical Research
https://www.readbyqxmd.com/read/27467103/dialytic-dose-in-pediatric-continuous-renal-replacement-therapy-patients
#15
Zaccaria Ricci, Francesco Guzzi, Germana Tuccinardi, Stefano Romagnoli
Although universally recognized as a crucial component of renal replacement therapy (RRT), dialytic dose has not been investigated in children with renal failure, differently from the adult population. Consequently, clear indications on the adequacy of continuous RRT in pediatric population is currently missing and wide variations in clinical practice exist worldwide. Fluid balance has been identified as a key factor in affecting outcomes these patients. Nonetheless, the concept and the precise evaluation of the dialytic dose for continuous pediatric RRT seems crucial, especially in light of the small body surface area of neonates and infants that might result into a difficult dose calculation...
October 2016: Minerva Pediatrica
https://www.readbyqxmd.com/read/27408001/an-initial-experience-of-continuous-peritoneal-dialysis-in-children-in-the-armed-forces
#16
M Kanitkar, H R Ramamurthy
BACKGROUND: Continuous peritoneal dialysis (CPD) is a modality of renal replacement therapy in children with renal failure. A retrospective study analysis of CPD data over four years at our center was carried out. METHODS: Ten children with renal failure on CPD were included. Depending on the supply, peritoneal dialysis (PD) fluids of two different brands were used in the same patients over time. The patient months of CPD were divided into two groups based on the brand of PD fluid used...
July 2007: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/27347761/effect-of-continuous-renal-replacement-therapy-on-outcome-in-pediatric-acute-liver-failure
#17
Akash Deep, Claire E Stewart, Anil Dhawan, Abdel Douiri
OBJECTIVES: To establish the effect of continuous renal replacement therapy on outcome in pediatric acute liver failure. DESIGN: Retrospective cohort study. SETTING: Sixteen-bed PICU in a university-affiliated tertiary care hospital and specialist liver centre. PATIENTS: All children (0-18 yr) admitted to PICU with pediatric acute liver failure between January 2003 and December 2013. INTERVENTIONS: Children with pediatric acute liver failure were managed according to a set protocol...
October 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27312907/is-regional-citrate-anticoagulation-the-future-of-hemodialysis
#18
Jadranka Buturovic-Ponikvar
Citrate has many characteristics of the ideal anticoagulant for hemodialysis. In addition to immediate and complete anticoagulation in the dialysis circuit, citrate has important effects beyond anticoagulation, mainly in reducing inflammatory response induced by hemodialysis. Citrate has already become the standard anticoagulant in acute kidney injury requiring continuous renal replacement therapy (CRRT), both for adults and children, with the citrate module being a part of modern CRRT monitors. Although the citrate module is not yet available for intermittent hemodialysis, precise infusion pumps, point-of-care ionometers and high citrate clearance from high flux dialyzers increase safety while reducing the risk of metabolic complications, both in adult and pediatric patients...
June 2016: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/27270721/neonatal-extracorporeal-renal-replacement-therapy-a-routine-renal-support-modality
#19
EDITORIAL
Leyat Tal, Joseph R Angelo, Ayse Akcan-Arikan
Peritoneal dialysis (PD) is generally considered the preferred extracorporeal therapy for neonates with acute kidney injury (AKI). However, there are situations when PD is not suitable, such as in patients with previous abdominal surgery, hyperammonemia and significant ascites or anasarca. Additionally, with a need to start PD soon after catheter placement, there is increased risk of PD catheter leak and infection. Extracorporeal continuous renal replacement therapy (CRRT) is challenging in severely ill neonates as it requires obtaining adequately sized central venous access to accommodate adequate blood flow rates and also adaptation of a CRRT machine meant for older children and adults...
November 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27180178/efficacy-and-outcomes-of-continuous-peritoneal-dialysis-versus-daily-intermittent-hemodialysis-in-pediatric-acute-kidney-injury
#20
Biswanath Basu, Tapan Kumar Sinha Mahapatra, Birendranath Roy, Franz Schaefer
BACKGROUND: Acute kidney injury (AKI) requiring renal replacement therapy (RRT) is associated with high patient morbidity and mortality. There is no consensus on the best RRT modality for pediatric AKI. METHODS: The efficacy and safety of continuous peritoneal dialysis (cPD) and daily intermittent hemodialysis (dHD) were compared in 136 children aged 1 month to 16 years requiring RRT for AKI. Mortality, risk factors and causes of death, 1-month and 3-month renal recovery rates, and technique-related complications were assessed...
October 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
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