title: Use of pump-assisted hemofiltration in children with acute renal failure.
abstract: In critically ill children, acute renal failure (ARF) is associated with a high mortality. To assess the outcome and complications of pump-assisted hemofiltration (PAHF) using a standard volumetric pump to regulate blood flow, we retrospectively reviewed our experience in 52 patients with ARF treated with PAHF from 1989 to 1995. These patients ranged in age from < 1 month to 19 years and in weight from 2 to 125 kg. The most common underlying diagnoses were congenital heart disease and infection. The duration of PAHF averaged 9 +/- 8 days (range 24 h to 43 days). Hemodiafiltration for solute control was required in 40 patients. Total fluid intake while on PAHF was 136 +/- 95 ml/kg per day, while urine output and ultrafiltration averaged 15 +/- 24 ml/kg per day and 89 +/- 58 ml/kg per day, respectively. Management of laboratory abnormalities was efficient with only 4 patients requiring 1 or 2 additional treatments of hemodialysis for control of uremia. Complications included hyponatremia in 13 patients, hypokalemia in 14 patients, hypovolemia in 8 patients, hyperglycemia in 6 patients, and bleeding in 9 patients. No complications specifically related to use of the volumetric infusion pump for PAHF were noted. PAHF using a volumetric infusion pump for blood flow regulation in critically ill children with ARF is a practical and efficient therapy.
authors.affiliation: University of Arkansas for Medical Sciences, Little Rock, USA.
authors.forename: E N
authors.initials: EN
authors.lastname: Ellis
authors.forename: D
authors.initials: D
authors.lastname: Pearson
authors.forename: C W
authors.initials: CW
authors.lastname: Belsha
authors.forename: P L
authors.initials: PL
authors.lastname: Berry
mesh_terms: D058186:Acute Kidney Injury / Q000378:metabolism / Q000628:therapy*; D000293:Adolescent; D000925:Anticoagulants / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D005260:Female; D006440:Hemofiltration / Q000009:adverse effects / Q000295:instrumentation*; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007260:Infusion Pumps; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014462:Ultrafiltration
chemical_list: D000925:Anticoagulants; D006493:Heparin