ESPN 50th Annual Meeting

ESPN 2017


 
PEDIATRIC CONTINUOUS RENAL REPLACEMENT THERAPY- A REPORT OF SEVEN YEARS, THREE CENTERS
FILIZ YETIMAKMAN 1 SELMAN KESICI 2 MURAT TANYILDIZ 1 UMUT SELDA BAYRAKCI 3 BENAN BAYRAKCI 1

1- HACETTEPE UNIVERSITY FACULTY OF MEDICINE, PEDIATRIC INTENSIVE CARE UNIT
2- DR SAMI ULUS MATERNITY AND CHILDREN’S TRAINING AND RESEARCH HOSPITAL, PEDIATRIC INTENSIVE CARE UNIT
3- ANKARA YILDIRIM BEYAZIT UNIVERSITY DEPARTMENT OF PEDIATRIC NEPHROLOGY
 
Introduction:

 Continuous renal replacement therapies (CRRT) either as continuous venovenous hemofiltration(CVVH) or hemodiafiltration(CVVHD) are used frequently in critically ill children. Many clinical variables and technical issues are known to affect the result. The factors that could be modified to increase the success of renal replacement are sought. As a contribution, we present the data on 104 patients who underwent CRRT within a seven years period.


Material and methods:

 A hundred and four patients admitted between 2009 and 2016 were included in the study. The demographic information, admittance PRISM (Pediatric Risk of Mortality) scores, indication for CRRT, presence of fluid overload, CRRT modality, durations of CRRT and PICU stay were compared between survivors and nonsurvivors.


Results:

 The overall rate of survival was 51%. Patients with fluid overload had significantly increased rate of death, CRRT duration and PICU stay. Multiorgan dysfunction syndrome as the indication for CRRT, was significantly related with decreased survival when compared to acute renal failure and acute attacks of metabolic diseases. CRRT modality was not different between survivors and nonsurvivors. SMR (Standardized mortality ratio) of the group was calculated to be 0.8.


Conclusions:

 CRRT in critically ill patients is successful in achieving the primary targets of therapy. It has a positive effect on expected mortality in high risk PICU patients. To affect the outcome, follow up should be focused on starting therapy in early stages of fluid overload. Prospective studies defining relative importance of risk factors causing mortality can assist in building up guidelines to affect the outcome.