Renal replacement therapies for critically ill pediatric patients.
It could be a great challenge for a nephrologist to prescribe a renal replacement therapy for a critically ill, hemodynamically unstable pediatric patient. Intermittent hemodialysis and peritoneal dialysis frequently fall short of being an optimal renal replacement therapy for such a patient. Continuous hemofiltration is offering new alternatives that can deliver sufficient clearance to meet the needs of a critically ill child. High fluid intake required for total parenteral nutrition and medications can easily be fulfilled by these modalities without compromising the cardivascular system. Of these techniques, continuous veno-venous hemofiltration is superior to continuous arterio-venous hemofiltration because it delivers a consistent ultrafiltration rate dependent on pump-driven blood flow and does not require the insertion of a large-bore catheter into an artery. Thus, various modalities of hemofiltration can offer an alternative to the critically ill child with acute renal failure.
Sakarcan
A
A
Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, USA.
Karaböcüoğlu
M
M
D058186:Acute Kidney Injury / Q000401:mortality / Q000628:therapy*; D002648:Child; D003422:Critical Care; D017583:Hemodiafiltration / Q000295:instrumentation / Q000379:methods; D006440:Hemofiltration / Q000009:adverse effects / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007223:Infant; D008297:Male