title: Continuous arteriovenous renal replacement systems for critically ill children.
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%.
authors.affiliation: Department of Paediatrics, University of Graz, Austria.
authors.forename: G
authors.initials: G
authors.lastname: Zobel
authors.forename: E
authors.initials: E
authors.lastname: Ring
authors.forename: V
authors.initials: V
authors.lastname: Zobel
mesh_terms: D058186:Acute Kidney Injury / Q000628:therapy*; D002675:Child, Preschool; D006440:Hemofiltration / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007022:Hypotension / Q000209:etiology; D006435:Renal Dialysis; D013396:Suction; D013997:Time Factors; D014462:Ultrafiltration