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continuous renal replacement therapy children

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https://www.readbyqxmd.com/read/27896442/regional-citrate-anticoagulation-for-continuous-renal-replacement-therapy-in-children
#1
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
#2
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...
October 27, 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
#3
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
#4
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...
September 1, 2016: Pharmaceutical Research
https://www.readbyqxmd.com/read/27467103/dialytic-dose-in-pediatric-continuous-renal-replacement-therapy-patients
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/27082273/dialytic-dose-in-pediatric-crrt-patients-systematic-review
#11
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...
April 15, 2016: Minerva Pediatrica
https://www.readbyqxmd.com/read/26998605/continuous-venovenous-hemodiafiltration-in-the-treatment-of-maple-syrup-urine-disease
#12
Demet Demirkol, Güntülü Şık, Nilüfer Topal, Agop Çıtak, Çigdem Zeybek, Abdülhamit Tüten, Ilmay Bilge
BACKGROUND: The study aims to define the efficacy of continuous renal replacement therapy in acute metabolic decompensation treatment of maple syrup urine disease (MSUD). METHODS: All the neonates, infants and children who have had life threatening conditions due to MSUD and were treated with continuous venovenous hemodiafiltration (CVVHDF) were analyzed retrospectively. RESULTS: Fourteen patients underwent 15 sessions of CVVHDF (age range 15 days to 87 months, mean 40...
2016: Blood Purification
https://www.readbyqxmd.com/read/26890194/continuous-infusion-vancomycin-through-the-addition-of-vancomycin-to-the-continuous-renal-replacement-therapy-solution-in-the-picu-a-case-series
#13
Jeffrey J Cies, Wayne S Moore, Susan B Conley, Samina Muneeruddin, Jason Parker, Paul Shea, Arun Chopra
OBJECTIVES: To describe our experience with achieving therapeutic serum vancomycin concentrations in pediatric continuous renal replacement therapy by using continuous infusion vancomycin by mixing vancomycin into the continuous renal replacement therapy solution. DESIGN: Retrospective chart review. SETTING: A 189-bed, freestanding children's tertiary care teaching hospital in Philadelphia, PA. PATIENTS: Pediatric patients receiving continuous renal replacement therapy from April 1, 2009, through December 31, 2014...
April 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/26881430/pediatric-continuous-renal-replacement-therapy
#14
Zaccaria Ricci, Stuart L Goldstein
BACKGROUND: Continuous renal replacement therapy (CRRT) and peritoneal dialysis are the preferred forms of dialysis delivery in critically ill children for the treatment of severe acute kidney injury. The epidemiology and the outcome of acute pediatric dialysis will be reviewed. SUMMARY: The prospective pediatric CRRT (pCRRT) registry has provided important epidemiologic information: pCRRT is required in about 5% of patients in pediatric intensive care units, and the mortality rate of these patients is about 60%...
2016: Contributions to Nephrology
https://www.readbyqxmd.com/read/26815660/what-is-this-chocolate-milk-in-my-circuit-a-cause-of-acute-clotting-of-a-continuous-renal-replacement-circuit-questions
#15
Aadil Kakajiwala, Kathleen Chiotos, Julie Brothers, April Lederman, Sandra Amaral
INTRODUCTION: One of the greatest problems associated with continuous renal replacement therapy (CRRT) is the early clotting of filters. A literature search revealed three case reports of lipemic blood causing recurrent clotting and reduced CRRT circuit survival time in adult patients, but no reports of cases in children. DIAGNOSIS/TREATMENT: A 23-month-old male infant with Martinez-Frias syndrome and multivisceral transplant was admitted to the hospital with severe sepsis and hemolytic anemia...
January 27, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/26730114/accuracy-of-a-real-time-continuous-glucose-monitoring-system-in-children-with-septic-shock-a-pilot-study
#16
Sumant Prabhudesai, Amruta Kanjani, Isha Bhagat, Karnam G Ravikumar, Bala Ramachandran
AIMS: The aim of this prospective, observational study was to determine the accuracy of a real-time continuous glucose monitoring system (CGMS) in children with septic shock. SUBJECTS AND METHODS: Children aged 30 days to 18 years admitted to the Pediatric Intensive Care Unit with septic shock were included. A real-time CGMS sensor was used to obtain interstitial glucose readings. CGMS readings were compared statistically with simultaneous laboratory blood glucose (BG)...
November 2015: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/26719818/assessment-of-worldwide-acute-kidney-injury-renal-angina-and-epidemiology-in-critically-ill-children-aware-a-prospective-study-to-improve-diagnostic-precision
#17
Rajit K Basu, Ahmad Kaddourah, Tara Terrell, Theresa Mottes, Patricia Arnold, Judd Jacobs, Jennifer Andringa, Melissa Armor, Lauren Hayden, Stuart L Goldstein
BACKGROUND: Acute kidney injury (AKI) is associated with poor outcomes in critically ill children. Recent international consensus panels recommend standardized classification systems to improve the precision of AKI diagnosis, but there is a paucity of data to enable this refinement, particularly in pediatric critical care. METHODS/DESIGN: This is a prospective observational study. We anticipate collecting data from more than 5500 critically ill children admitted to 32 pediatric intensive care units (PICUs) across the world, during the calendar year of 2014...
2015: Journal of Clinical Trials
https://www.readbyqxmd.com/read/26719674/association-of-systolic-blood-pressure-drop-with-intravenous-administration-of-itraconazole-in-children-with-hemato-oncologic-disease
#18
Hyeong Jin Lee, Bongjin Lee, June Dong Park, Hyung Joo Jeong, Yu Hyeon Choi, Hee Young Ju, Che Ry Hong, Ji Won Lee, Hyery Kim, Dong In Suh, Kyung Duk Park, Hyoung Jin Kang, Hee Young Shin, Hyo Seop Ahn
PURPOSE: Although few adverse effects have been reported for itraconazole, a widely used antifungal therapy for febrile neutropenia, we found intravenous (IV) itraconazole to be associated with serious cases of blood pressure (BP) drop. We therefore evaluated the incidence and risk factors for BP drop during IV administration of the drug. MATERIALS AND METHODS: We reviewed the medical records of children with hemato-oncologic disease who were treated with IV itraconazole from January 2012 to December 2013...
2015: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/26709896/drug-dosage-in-continuous-venoveno-hemofiltration-in-critically-ill-children
#19
REVIEW
Farahnak Assadi, Fatemeh Ghane Shahrbaf
The dosage of drugs in patients requiring continuous renal replacement therapy need to be adjusted based on a number of variables that that affect pharmacokinetics (PK) including patient weight, CRRT modality (convention, vs. diffusion), blood and/or effluent flow, hemofilter characteristics, physiochemical drug properties, volume of distribution, protein binding and half-life as well as residual renal function. There is a paucity of data on PK studies in children with acute kidney injury requiring CRRT. When possible, therapeutic drug monitoring should be utilized for those medications where serum drug concentrations can be obtained in a clinically relevant time frame...
2016: Frontiers in Bioscience (Scholar Edition)
https://www.readbyqxmd.com/read/26687178/early-initiation-of-renal-replacement-therapy-in-pediatric-heart-surgery-is-associated-with-lower-mortality
#20
Joan Sanchez-de-Toledo, Alba Perez-Ortiz, Laura Gil, Tracy Baust, Marcos Linés-Palazón, Santiago Perez-Hoyos, Ferran Gran, Raul F Abella
Acute kidney injury (AKI) is frequent in the postoperative period of pediatric heart surgery and leads to significant morbidity and mortality. Renal replacement therapies (RRTs) are often used to treat AKI; however, these therapies have also been associated with higher mortality rates. Earlier initiation of RRT might improve outcomes. This study aims to investigate the relationship between the RRT and morbidity and mortality after pediatric heart surgery. We performed a single-center retrospective study of all children undergoing pediatric heart surgery between April 2010 and December 2012 at a tertiary children's hospital...
April 2016: Pediatric Cardiology
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