title: Plasma exchange using a continuous venovenous hemofiltration machine in children.
abstract: BACKGROUND
  There is considerable interest in using continuous venovenous hemofiltration machines for plasma exchange therapy in children.
  
  
  METHODS
  Retrospective study of 7 patients and 61 plasma exchange treatments using the Baxter/Edwards Lifesciences BM25 machine with commercially available plasma filters (mostly Asahi Plasmaflo).
  
  
  RESULTS
  The average total exchange volume was 1.5 times the plasma volume, achieved at a blood flow rate of 100 ml/m(2) (3.5 ml/kg/min) and a turnover rate of 25 ml/kg/h over a 3-hour duration. Fifty-six percent of the time, a mean heparin bolus of 29 units/kg resulted in subtherapeutic activated clotting times. Mean heparin infusion rates of 35 units of heparin/kg/h achieved effective anticoagulation. A calcium infusion rate of 0.11 +/- 0.05 mmol/kg/h avoided hypocalcemia. One patient experienced the serious complication of membrane reaction.
  
  
  CONCLUSIONS
  This setup provides a safe approach to plasma exchange in children. A similar method could be implemented in other centers.
authors.affiliation: Department of Pediatrics, Division of Nephrology, Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada.
authors.forename: Ewa
authors.initials: E
authors.lastname: Ciechanska
authors.forename: Lauren
authors.initials: L
authors.lastname: Segal
authors.forename: Hubert
authors.initials: H
authors.lastname: Wong
authors.forename: Christine
authors.initials: C
authors.lastname: Chretien
authors.forename: Janusz
authors.initials: J
authors.lastname: Feber
authors.forename: Guido
authors.initials: G
authors.lastname: Filler
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006440:Hemofiltration / Q000295:instrumentation / Q000379:methods; D006801:Humans; D008297:Male; D010865:Pilot Projects; D010951:Plasma Exchange / Q000295:instrumentation / Q000379:methods; D012189:Retrospective Studies