Abstract
Five different arteriovenous renal replacement systems were used to treat 23 critically ill oliguric or anuric children. Slow continuous ultrafiltration (SCU) was carried out for 8 patient days, continuous arteriovenous haemofiltration (CAVH) for 40, suction-supported CAVH for 56, continuous or intermittent arteriovenous haemodiafiltration (AVHDF) for 3, and continuous arteriovenous haemodialysis (CAVHD) for 24 days. SCU allowed excellent control of fluid overload in 4 patients within 47±17 h. Urea clearances ranged from 5.6±2.1 ml/min per m2 (spontaneous CAVH) to 15.3±3.7 ml/min per m2 (CAVHD) and enabled good control of azotaemia. Ultrafiltration rates of the different filters ranged from 1.6±0.3 to 11.5±2.4 ml/min per m2. The only serious complication was a femoral artery thrombosis in a 1.5-year-old boy. Minor side-effects were local bleeding at the entrance site of the arterial catheter and transient hypotension during suction-supported CAVH. Of 23 patients, 8 died because of progressive multiple organ system failure, a mortality of 35%.
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Maxwell LG, Fivush BA, McLean RH (1987) Renal failure. In: Rogers MC (ed) Textbook of pediatric intensive care. Williams and Wilkins, Baltimore, pp 1001–1055
Swartz RD (1984) Interventive support for acute renal failure in the critically ill patient. In: Bartlett RH, Whitehouse WM, Turcotte JG, Harper ML (eds) Life support systems in intensive care. Year Book Medical Publishers, Chicago, pp 409–431
Olbricht CJ (1986) Continuous arteriovenous hemofiltration — the control of azotemia in acute renal failure. In: Paganini EP (ed) Acute continuous renal replacement therapy. Martinus Nijhoff, Boston, pp 123–141
Kaplan AA, Longnecker RE, Folkert VW (1983) Suction assisted continuous arteriovenous hemofiltration. Trans Am Soc Artif Intern Organs 29: 408–413
Ronco C, Brendolan A, Bragantini L, Chiaramonte S, Dell'Aguilla R, Fabris A, Feriani M, Milan M, LaGreca G (1986) Arteriovenous hemofiltration associated with continuous arteriovenous hemodiafiltration: a combined therapy for acute renal failure in the hypercatabolic patients. In: LaGreca G, Fabris A, Ronco C (eds) Proceedings of the International Symposium on Continuous Arteriovenous Hemofiltration. Wichtig, Milan, pp 171–183
Geronemus R, Schneider N (1986) Continuous arteriovenous hemodialysis — clinical experience. In: Papanini EP (ed) Acute continuous renal replacement therapy. Martinus Nijhoff, Boston, pp 123–141
Zobel G, Ring E, Trop M, Grubbauer HM (1988) Suction supported continuous arteriovenous hemofiltration in children. Blood Purif 6: 37–42
Zobel G, Ring E, Trop M, Stein JI (1986) Arteriovenous hemodiafiltration in children. Int J Pediatr Nephrol 7: 203–206
Lauer A, Saccaggi A, Ronco C, Belledonne M, Glabman S, Bosch JB (1983) Continuous arteriovenous hemofiltration in the critically ill patient. Ann Intern Med 99: 455–460
Kaplan AA, Longnecker RE, Folkert VW (1984) Continuous arteriovenous hemofiltration. Ann Intern Med 100: 358–367
Papanini EP (1987) Continuous renal prosthetic therapy in acute renal failure: an overview. Pediatr Clin North Am 34: 165–185
Kramer P, Wigger W, Rieger J, Mathaei D, Scheler F (1977) Arteriovenous hemofiltration: a new and simple method for the treatment of overhydrated patients resistant to diuretics. Klin Wochenschr 55: 1121–1122
Ronco C, Brendolan A, Biasioli S, Chiaramontes, Fabris A, Feriani M, LaGreca G (1984) Self-limited dehydration during continuous a-v hemofiltration. Blood Purif 2: 88–92
Kaplan AA (1986) Enhanced efficiency during CAVH: clinical trials with predilution and vacuum suction. In: La Greca G, Fabris A, Ronco C (eds) Proceedings of the International Symposium on Continuous Arteriovenous Hemofiltration. Wichtig, Milan, pp 49–54
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Zobel, G., Ring, E. & Zobel, V. Continuous arteriovenous renal replacement systems for critically ill children. Pediatr Nephrol 3, 140–143 (1989). https://doi.org/10.1007/BF00852895
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DOI: https://doi.org/10.1007/BF00852895