Abstract
(1507) - Therapeutic Ultrafiltration to Treat Symptomatic Pediatric Heart Failure
The Journal of heart and lung transplantation, Vol.45(5 Supplement), pp.692-693
07/2026
DOI: 10.1016/j.healun.2026.02.1521
Abstract
Purpose: Pediatric heart failure is rare, and treatment options for fluid overload are limited. Therapeutic ultrafiltration, frequently used in adults, has not been widely utilized for pediatric heart failure symptoms. This case explores the use of ultrafiltration in a pediatric patient with chemotherapy-induced dilated cardiomyopathy and recurrent fluid overload, aiming to evaluate its feasibility, safety, and clinical impact.
Methods: A 12-year-old, 38 kg female with history of chemotherapy-induced dilated cardiomyopathy on multiple diuretic and heart failure agents, who experienced recurrent hospital admissions for fluid overload, chest pain, dyspnea, and ascites. Ultrafiltration was performed over two consecutive days, removing a total of 2.5 liters of isotonic fluid. This was initially accomplished using a dual-lumen extended-length catheter (dELC); however, catheter malfunction led to its removal. The following day, ultrafiltration was successfully accomplished with two 20-gauge single-lumen peripheral IVs. Data collected included creatinine levels and pulmonary artery pressures, monitored via a previously deployed manometer.
Results: The patient remained hemodynamically stable throughout the procedures. Side effects included emesis and lightheadedness without syncope, which resolved with rest. Baseline outpatient creatinine improved from 0.69 mg/dL pre-admission to 0.54 mg/dL post-admission. Mean pulmonary artery pressure decreased from 32 mmHg to 25 mmHg. The patient was discharged the day after the second ultrafiltration session.
Conclusion: Ultrafiltration was successfully and safely performed in a pediatric patient using the dELC and, subsequently, two single-lumen IV's—a novel approach not described in literature. The procedure led to improved renal function and pulmonary pressures with minimal side effects. These findings suggest ultrafiltration may be a valuable adjunct to diuretic therapy or other pharmacologic interventions, potentially preventing recurrent hospitalization while optimizing resource utilization, improve the clinical status of those awaiting heart transplant, and may contribute to better post-transplant outcomes. Further investigation and utilization of ultrafiltration in pediatric heart failure patients is therefore warranted.
Details
- Title: Subtitle
- (1507) - Therapeutic Ultrafiltration to Treat Symptomatic Pediatric Heart Failure
- Creators
- A.J. Heaps - University of Iowa Stead Family Children’s HospitalK. Merrill - University of Iowa Stead Family Children’s HospitalB Van Wyk - University of IowaM. Staron-Ehlinger - University of IowaM. Luangrath - University of Iowa, Critical CareG. Beasley - University of Iowa, Cardiology
- Resource Type
- Abstract
- Publication Details
- The Journal of heart and lung transplantation, Vol.45(5 Supplement), pp.692-693
- DOI
- 10.1016/j.healun.2026.02.1521
- ISSN
- 1053-2498
- Publisher
- Elsevier Inc
- Number of pages
- 2
- Language
- English
- Date published
- 07/2026
- Academic Unit
- Critical Care; Cardiology; Nephrology, Dialysis and Transplantation; Stead Family Department of Pediatrics
- Record Identifier
- 9985156431002771
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