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Pediatric CRRT

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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/27851259/1624-ecmo-crrt-configuration-in-two-pediatric-septic-shock-patients
#2
Tanya Chadha, Thomas Beaulieu, Fredrick Hill, Laura Malaga-Dieguez, Jason Fisher, Arun Chopra
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27696656/treatment-for-childhood-acute-lymphoblastic-leukemia-in-taiwan-taiwan-pediatric-oncology-group-all-2002-study-emphasizing-optimal-reinduction-therapy-and-central-nervous-system-preventive-therapy-without-cranial-radiation
#3
Meng-Ju Li, Hsi-Che Liu, Hsiu-Ju Yen, Tang-Her Jaing, Dong-Tsamn Lin, Chao-Ping Yang, Kai-Hsin Lin, Iou-Jih Hung, Shiann-Tarng Jou, Meng-Yao Lu, Chih-Cheng Hsiao, Ching-Tien Peng, Tai-Tsung Chang, Shih-Chung Wang, Ming-Tsan Lin, Jiann-Shiuh Chen, Te-Kau Chang, Giun-Yi Hung, Kang-Hsi Wu, Yung-Li Yang, Hsiu-Hao Chang, Shih-Hsiang Chen, Ting-Chi Yeh, Chao-Neng Cheng, Pei-Chin Lin, Shyh-Shin Chiou, Jiunn-Ming Sheen, Shin-Nan Cheng, Shu-Huey Chen, Yu-Hsiang Chang, Wan-Ling Ho, Yu-Hua Chao, Rong-Long Chen, Bow-Wen Chen, Jinn-Li Wang, Yuh-Lin Hsieh, Yu-Mei Liao, Shang-Hsien Yang, Wan-Hui Chang, Yu-Mei Y Chao, Der-Cherng Liang
BACKGROUND: Reinduction therapy has improved the outcomes in children with acute lymphoblastic leukemia (ALL). We sought to determine the optimal course(s) of reinduction therapy for standard-risk (SR, or "low-risk" in other groups) patients. Also, we evaluated outcomes using triple intrathecal therapy without cranial radiation (CrRT) for central nervous system (CNS) preventive therapy. PROCEDURE: From 2002 to 2012, all newly diagnosed children with ALL in Taiwan were enrolled in Taiwan Pediatric Oncology Group ALL-2002 protocol...
October 3, 2016: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/27336018/improvement-of-oxygenation-in-severe-acute-respiratory-distress-syndrome-with-high-volume-continuous-veno-venous-hemofiltration
#4
Wenmin Yang, Jie Hong, Qiyi Zeng, Jianping Tao, Feiyan Chen, Run Dang, Yufeng Liang, Zhiyuan Wu, Yiyu Yang
The efficacy and therapeutic mechanisms of continuous renal replacement therapy (CRRT) for improvement of oxygenation in acute respiratory distress syndrome (ARDS) remain controversial. These questions were addressed by retrospective analysis of severe ARDS patients admitted to the pediatric intensive care unit of our hospital from 2009 to 2015 who received high-volume continuous veno-venous hemofiltration during mechanical ventilation. There was a significant improvement in partial oxygen pressure/fraction of inspired oxygen (PaO2/FiO2) 24 hours after CRRT onset compared with baseline (median change = 51...
2016: Global Pediatric Health
https://www.readbyqxmd.com/read/27312907/is-regional-citrate-anticoagulation-the-future-of-hemodialysis
#5
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
#6
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/27082273/dialytic-dose-in-pediatric-crrt-patients-systematic-review
#7
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/27025149/development-of-online-learning-modules-as-an-adjunct-to-skills-fairs-and-lectures-to-maintain-nurses-competency-and-comfort-level-when-caring-for-pediatric-patients-requiring-continuous-renal-replacement-therapy-crrt
#8
Kimberly Windt
Continuous renal replacement therapy (CRRT) for pediatric patients is an extremely specialized therapy requiring knowledge of the patient's diagnosis, understanding of the principles of the therapy, astute patient assessment, and proficiency with complicated equipment. The complexity of CRRT is compounded by its relatively rare occurrence, in the pediatric population. Maintaining staff competency with this high-risk/low-volume therapy is extremely difficult. This article discusses the development and implementation of a structured system and set of resources to support routine education, and the development of two online, interactive learning modules to provide additional exposure to GRRT throughout the year...
January 2016: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
https://www.readbyqxmd.com/read/26881430/pediatric-continuous-renal-replacement-therapy
#9
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
#10
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/26687178/early-initiation-of-renal-replacement-therapy-in-pediatric-heart-surgery-is-associated-with-lower-mortality
#11
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
https://www.readbyqxmd.com/read/26628828/continuous-renal-replacement-therapy-in-children-with-severe-sepsis-and-multiorgan-dysfunction-a-pilot-study-on-timing-of-initiation
#12
Krishna Mohan Gulla, Anil Sachdev, Dhiren Gupta, Neeraj Gupta, Kanav Anand, P K Pruthi
OBJECTIVE: Scanty literature is available regarding continuous renal replacement therapy (CRRT) utility in severe sepsis with multiorgan dysfunction syndrome (MODS) from developing countries. Author unit's experience in pediatric CRRT is described and outcome of early initiation of CRRT with sepsis and MODS is assessed. MATERIALS AND METHODS: Children aged <16 years with sepsis and MODS who required CRRT from September 2010 to February 2015 were analyzed on demographic factors, timing of initiation of CRRT, mode of CRRT, effect of CRRT onhemodynamics, oxygenation parameters, and outcome...
October 2015: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/26569779/118-recovery-of-renal-function-in-pediatric-patients-supported-by-ecmo-and-crrt
#13
Nakano Satoshi, Masaki Osaki, Shinya Miura
No abstract text is available yet for this article.
December 2015: Critical Care Medicine
https://www.readbyqxmd.com/read/26265013/carnitine-deficiency-in-children-receiving-continuous-renal-replacement-therapy
#14
Kristen Sgambat, Asha Moudgil
Carnitine deficiency is known to occur in chronic hemodialysis; however, the effect of continuous renal replacement therapy (CRRT) on carnitine homeostasis has not been studied. We hypothesized that children receiving CRRT are at risk for deficiency because of continuous removal, absent intake, decreased production, and comorbidities related to critical illness. Records of patients with acute kidney injury receiving CRRT at Children's National Health System between 2011 and 2014 were reviewed for total carnitine (TC), free carnitine (FC), feeding modality, severity of illness, and survival outcome...
January 2016: Hemodialysis International
https://www.readbyqxmd.com/read/25960300/-r-evolution-in-the-management-of-acute-kidney-injury-in-newborns
#15
Claudio Ronco, Zaccaria Ricci, Stuart L Goldstein
The application of continuous renal replacement therapy (CRRT) in children, before roller pumps and dialysis monitors were available in the intensive care unit, was realized by continuous arteriovenous hemofiltration. Then hemofiltration was coupled with dialysis in order to increase dialytic dose and system efficiency, and the circuit and filters were specifically modified to optimize patency and session life span. After about 30 years, another revolution is ongoing, in that pediatric acute kidney injury (AKI) and fluid accumulation (for which critically ill newborns and children with multiple-organ dysfunction are greatly at risk) are recognized as independently associated with mortality and identified as primary conditions to prevent and aggressively treat...
August 2015: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/25894625/pediatric-continuous-renal-replacement-20%C3%A2-years-later
#16
Claudio Ronco, Zaccaria Ricci
INTRODUCTION: More than 20 years have passed since the first clinical application of continuous renal replacement therapy (CRRT) in children. In that revolutionary era, before roller pumps and dialysis monitors for intensive care units were readily available, continuous arteriovenous hemofiltration was the most common treatment for critically ill children. MAJOR FINDINGS: Those steps were the basis for current knowledge about modern CRRT. Research on circuit rheology and filter materials allowed for the improvement of materials, and the optimization of patency and session life spans...
June 2015: Intensive Care Medicine
https://www.readbyqxmd.com/read/25860636/retrospective-evaluation-of-milrinone-pharmacokinetics-in-children-with-kidney-injury
#17
Katja M Gist, Tomoyuki Mizuno, Stuart L Goldstein, Alexander Vinks
OBJECTIVES: Milrinone is an inotropic agent with vasodilating properties used in the treatment of ventricular dysfunction. Milrinone is predominantly eliminated by the kidneys and accumulates in the setting of acute kidney injury (AKI). The purpose of this study was to evaluate milrinone pharmacokinetics in children with AKI with or without continuous renal replacement therapy (CRRT). METHODS: Retrospective collection of milrinone therapeutic drug monitoring data in patients with AKI, including those requiring CRRT, through chart review from January 2008 to March 2014...
December 2015: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/25683273/-long-term-outcomes-of-children-treated-with-continuous-renal-replacement-therapy
#18
S Almarza, K Bialobrzeska, M M Casellas, M J Santiago, J López-Herce, B Toledo, Á Carrillo
INTRODUCTION: The objective of this study is to analyze long-term outcomes and kidney function in children requiring continuous renal replacement therapy (CRRT) after an acute kidney injury episode. PATIENTS AND METHODS: A retrospective observational study was performed using a prospective database of 128 patients who required CRRT admitted to the pediatric intensive care unit between years 2006 and 2012. The subsequent outcomes were assessed in those surviving at hospital discharge...
December 2015: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/25656009/outcome-of-patients-on-combined-extracorporeal-membrane-oxygenation-and-continuous-renal-replacement-therapy-a-retrospective-study
#19
Bijin Thajudeen, Mahmoud Kamel, Cibi Arumugam, Syed Asad Ali, Santhosh G John, Edward E Meister, Jarrod M Mosier, Yuval Raz, Machaiah Madhrira, Jess Thompson, Amy N Sussman
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is a lifesaving therapy used in the management of cardiopulmonary failure. Continuous renal replacement therapy (CRRT) is often added to the treatment for the correction of fluid and electrolyte imbalance in patients with acute kidney injury. Most of the literature on the use of combined ECMO and CRRT has been on pediatric patients. There are limited outcome data on the use of these combined modalities in adult patients. METHODS: This is a retrospective analysis of all the patients above the age of 18 years who underwent combined ECMO and CRRT at a tertiary care medical center during the period January 2007 to January 2012...
March 2015: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/25615255/continuous-renal-replacement-therapy-in-children-with-multiple-organ-dysfunction-syndrome-a-case-series
#20
Yan-lin Zhang, Wei-ping Hu, Ling-hui Zhou, Yin Wang, Ao Cheng, Si-nan Shao, Ling-Ling Hong, Qiu-yue Chen
There is a lack of definitive information regarding the precise indications, implementation, and outcomes of continuous renal replacement therapy (CRRT) for the treatment of critically ill children. Six children (three boys, three girls) aged from 3 days to 8 years, all of whom had multiple organ failure, were submitted to bedside CRRT using M60 filter membranes. Modified Port carbonate formula was used and clotting time was maintained between 20 and 30 minutes. Activated partial thromboplastin time was 1.5- to 2-fold normal...
November 2014: International Braz J Urol: Official Journal of the Brazilian Society of Urology
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